Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $11.75 / $13.80	Facility	26	$10.47	$11.75	$13.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $117.49	Professional		$27.54	$41.69	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.33 / $19.05	Professional	26	$7.94	$9.33	$19.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $48.98	Professional	TC	$19.05	$28.84	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $75.86	Professional		$32.36	$46.77	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $23.44	Professional	26	$8.91	$13.18	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $52.48	Professional	TC	$22.91	$32.36	$52.48
HMSA Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $61.66	Professional		$40.74	$58.88	$61.66
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $13.80 / $14.45	Professional	26	$13.49	$13.80	$14.45
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $46.77	Professional	TC	$44.67	$44.67	$46.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $54.95 / $64.57	Professional		$50.12	$54.95	$64.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.88 / $14.79	Professional	26	$11.75	$12.88	$14.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $41.69 / $48.98	Professional	TC	$38.90	$41.69	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $52.48 / $81.28	Professional		$47.86	$52.48	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $13.80 / $21.38	Professional	26	$12.02	$13.80	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $37.15 / $57.54	Professional	TC	$36.31	$37.15	$57.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $64.57 / $81.28	Professional		$44.67	$64.57	$81.28
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $23.99	Professional	26	$12.02	$15.85	$23.99
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $50.12 / $60.26	Professional	TC	$32.36	$50.12	$60.26