Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.76 / $13.32 / $15.67	Facility	26	$11.76	$13.32	$15.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $48.43 / $79.93	Professional		$40.39	$48.43	$79.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $10.45 / $17.96	Professional	26	$9.41	$10.45	$17.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.98 / $37.97 / $61.97	Professional	TC	$30.98	$37.97	$61.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.17 / $53.60 / $71.00	Professional		$44.17	$53.60	$71.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $13.31 / $16.48	Professional	26	$11.88	$13.31	$16.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $37.11 / $54.90	Professional	TC	$32.29	$37.11	$54.90
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.95 / $62.04 / $66.95	Professional		$13.95	$62.04	$66.95
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $15.29 / $16.01 / $16.41	Professional	26	$15.29	$16.01	$16.41
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $46.75 / $48.95 / $48.95	Professional	TC	$46.75	$48.95	$48.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $57.86 / $67.51	Professional		$53.04	$57.86	$67.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.77 / $13.93 / $16.25	Professional	26	$12.77	$13.93	$16.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.26 / $43.92 / $46.48	Professional	TC	$40.26	$43.92	$46.48
United Facility/Professional Professional Modifier Low / Median / High Price $23.55 / $65.09 / $72.53	Professional		$23.55	$65.09	$72.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.14 / $15.67 / $19.53	Professional	26	$7.14	$15.67	$19.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.41 / $49.41 / $53.00	Professional	TC	$16.41	$49.41	$53.00
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.85 / $71.81 / $98.82	Professional		$47.85	$71.81	$98.82
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.65 / $16.93 / $22.90	Professional	26	$10.65	$16.93	$22.90
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $37.61 / $55.06 / $76.38	Professional	TC	$37.61	$55.06	$76.38