Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $13.80 / $16.22	Facility	26	$12.02	$13.80	$16.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $169.82	Professional		$28.84	$46.77	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.30 / $52.48	Professional	26	$7.94	$12.30	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.90 / $47.86	Professional	TC	$20.89	$30.90	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $47.86 / $79.43	Professional		$34.67	$47.86	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.88 / $22.91	Professional	26	$9.33	$12.88	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $57.54	Professional	TC	$25.12	$34.67	$57.54
HMSA Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $69.18	Professional		$43.65	$58.88	$69.18
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $16.22 / $16.98	Professional	26	$15.85	$16.22	$16.98
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $45.71 / $52.48	Professional	TC	$43.65	$45.71	$52.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $57.54 / $66.07	Professional		$52.48	$57.54	$66.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $15.14 / $17.78	Professional	26	$13.80	$15.14	$17.78
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 $48.98 / $56.23 / $83.18	Professional		$48.98	$56.23	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $24.55	Professional	26	$12.88	$16.22	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $39.81 / $56.23	Professional	TC	$35.48	$39.81	$56.23
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $85.11	Professional		$45.71	$67.61	$85.11
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $17.38 / $22.91	Professional	26	$11.75	$17.38	$22.91
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $50.12 / $63.10	Professional	TC	$35.48	$50.12	$63.10