Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.85 / $16.82 / $19.80	Facility	26	$14.85	$16.82	$19.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.79 / $39.44 / $46.40	Facility	TC	$34.79	$39.44	$46.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.95 / $45.05 / $80.95	Professional		$37.95	$45.05	$80.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $16.32 / $22.75	Professional	26	$14.44	$16.32	$22.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $28.35 / $58.20	Professional	TC	$23.51	$28.35	$58.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.23 / $55.62 / $66.20	Professional		$46.23	$55.62	$66.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $18.59 / $22.01	Professional	26	$16.82	$18.59	$22.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.64 / $34.52 / $46.40	Professional	TC	$27.64	$34.52	$46.40
HMSA Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $23.33 / $64.06	Professional		$17.25	$23.33	$64.06
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $18.91 / $19.80 / $20.29	Professional	26	$18.91	$19.80	$20.29
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.16 / $47.29 / $47.29	Professional	TC	$45.16	$47.29	$47.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.94 / $58.85 / $68.66	Professional		$53.94	$58.85	$68.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $17.60 / $20.54	Professional	26	$16.14	$17.60	$20.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.81 / $41.24 / $43.65	Professional	TC	$37.81	$41.24	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $24.61 / $61.79 / $75.19	Professional		$24.61	$61.79	$75.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $19.80 / $25.91	Professional	26	$9.34	$19.80	$25.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.27 / $46.40 / $49.28	Professional	TC	$15.27	$46.40	$49.28
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $60.76 / $77.67 / $114.37	Professional		$60.76	$77.67	$114.37
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $23.26 / $40.58	Professional	26	$18.14	$23.26	$40.58
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $42.62 / $52.66 / $72.30	Professional	TC	$42.62	$52.66	$72.30