Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $12.02 / $14.45	Facility	26	$10.72	$12.02	$14.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $43.65 / $204.17	Professional		$25.70	$43.65	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $50.12	Professional	26	$7.08	$14.13	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $30.20 / $61.66	Professional	TC	$18.20	$30.20	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $42.66 / $69.18	Professional		$29.51	$42.66	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.48 / $19.95	Professional	26	$8.32	$11.48	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $50.12	Professional	TC	$22.39	$30.90	$50.12
HMSA Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $56.23 / $57.54	Professional		$36.31	$56.23	$57.54
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $14.45 / $15.14	Professional	26	$13.80	$14.45	$15.14
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $40.74 / $42.66	Professional	TC	$40.74	$40.74	$42.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $51.29 / $60.26	Professional		$46.77	$51.29	$60.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.59 / $14.79	Professional	26	$11.75	$12.59	$14.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $38.90 / $44.67	Professional	TC	$35.48	$38.90	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $47.86 / $77.62	Professional		$45.71	$47.86	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $14.13 / $21.88	Professional	26	$11.75	$14.13	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $34.67 / $53.70	Professional	TC	$33.88	$34.67	$53.70
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $61.66 / $75.86	Professional		$38.90	$61.66	$75.86
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.85 / $19.95	Professional	26	$10.00	$15.85	$19.95
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $46.77 / $57.54	Professional	TC	$28.84	$46.77	$57.54