Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.09 / $10.30 / $12.12	Facility	26	$9.09	$10.30	$12.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.28 / $30.91 / $36.36	Facility	TC	$27.28	$30.91	$36.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $32.00 / $59.54	Professional		$26.78	$32.00	$59.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $12.56 / $21.00	Professional	26	$8.46	$12.56	$21.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $21.68 / $45.59	Professional	TC	$18.32	$21.68	$45.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.33 / $39.01 / $48.49	Professional		$32.33	$39.01	$48.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $10.86 / $13.19	Professional	26	$10.30	$10.86	$13.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $26.75 / $36.36	Professional	TC	$21.48	$26.75	$36.36
HMSA Facility/Professional Professional Modifier Low / Median / High Price $11.12 / $38.81 / $49.63	Professional		$11.12	$38.81	$49.63
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $11.71 / $12.49 / $13.08	Professional	26	$11.71	$12.49	$13.08
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $33.59 / $35.17 / $36.54	Professional	TC	$33.59	$35.17	$36.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.51 / $43.10 / $50.29	Professional		$39.51	$43.10	$50.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $10.78 / $12.57	Professional	26	$9.88	$10.78	$12.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.63 / $32.33 / $34.21	Professional	TC	$29.63	$32.33	$34.21
United Facility/Professional Professional Modifier Low / Median / High Price $17.32 / $48.49 / $53.24	Professional		$17.32	$48.49	$53.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.49 / $12.12 / $15.11	Professional	26	$5.49	$12.12	$15.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.84 / $36.36 / $38.13	Professional	TC	$11.84	$36.36	$38.13
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.50 / $54.71 / $81.14	Professional		$44.50	$54.71	$81.14
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $14.24 / $24.52	Professional	26	$11.10	$14.24	$24.52
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $33.04 / $39.92 / $56.60	Professional	TC	$33.04	$39.92	$56.60