Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $12.30 / $14.45	Facility	26	$10.72	$12.30	$14.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $134.90	Professional		$30.90	$46.77	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $47.86	Professional	26	$7.94	$10.96	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $63.10	Professional	TC	$21.88	$33.11	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $58.88 / $85.11	Professional		$38.02	$58.88	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.18 / $23.44	Professional	26	$9.77	$13.18	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $42.66 / $61.66	Professional	TC	$28.18	$42.66	$61.66
HMSA Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $63.10 / $66.07	Professional		$41.69	$63.10	$66.07
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.79 / $15.49	Professional	26	$14.45	$14.79	$15.49
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $45.71 / $47.86	Professional	TC	$45.71	$45.71	$47.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $56.23 / $64.57	Professional		$51.29	$56.23	$64.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $13.18 / $15.49	Professional	26	$12.02	$13.18	$15.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $42.66 / $50.12	Professional	TC	$38.90	$42.66	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $79.43	Professional		$47.86	$61.66	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.45 / $21.88	Professional	26	$12.59	$14.45	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $44.67 / $57.54	Professional	TC	$34.67	$44.67	$57.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $67.61 / $102.33	Professional		$53.70	$67.61	$102.33
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.22 / $23.99	Professional	26	$12.30	$16.22	$23.99
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $51.29 / $81.28	Professional	TC	$40.74	$51.29	$81.28