Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.16 / $14.92 / $17.55	Facility	26	$13.16	$14.92	$17.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.54 / $36.88 / $43.39	Facility	TC	$32.54	$36.88	$43.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $42.06 / $74.61	Professional		$35.39	$42.06	$74.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.53 / $14.15 / $20.18	Professional	26	$12.53	$14.15	$20.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $27.56 / $54.42	Professional	TC	$22.85	$27.56	$54.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $51.56 / $60.95	Professional		$43.02	$51.56	$60.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $16.14 / $19.50	Professional	26	$14.92	$16.14	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.87 / $33.22 / $43.39	Professional	TC	$26.87	$33.22	$43.39
HMSA Facility/Professional Professional Modifier Low / Median / High Price $15.19 / $20.55 / $58.93	Professional		$15.19	$20.55	$58.93
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $17.45 / $17.87	Professional	26	$16.66	$17.45	$17.87
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $42.27 / $44.26 / $44.26	Professional	TC	$42.27	$44.26	$44.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.67 / $54.18 / $63.21	Professional		$49.67	$54.18	$63.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $15.60 / $18.20	Professional	26	$14.30	$15.60	$18.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.35 / $38.57 / $40.82	Professional	TC	$35.35	$38.57	$40.82
United Facility/Professional Professional Modifier Low / Median / High Price $22.64 / $54.20 / $69.29	Professional		$22.64	$54.20	$69.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $21.87 / $104.85	Professional	26	$13.96	$21.87	$104.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.70 / $43.39 / $47.42	Professional	TC	$14.70	$43.39	$47.42
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $69.98 / $100.26	Professional		$41.03	$69.98	$100.26
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $19.76 / $34.27	Professional	26	$12.67	$19.76	$34.27
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $29.45 / $48.76 / $65.98	Professional	TC	$29.45	$48.76	$65.98