Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.20 / $16.09 / $18.93	Facility	26	$14.20	$16.09	$18.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $44.97 / $53.96 / $61.22	Facility	TC	$44.97	$53.96	$61.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $56.19 / $94.76	Professional		$44.27	$56.19	$94.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.63 / $19.59 / $48.20	Professional	26	$13.63	$19.59	$48.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $36.45 / $75.20	Professional	TC	$30.85	$36.45	$75.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $16.14	Facility	26	$16.14	$16.14	$16.14
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $44.74 / $44.74 / $44.74	Facility	TC	$44.74	$44.74	$44.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $64.45 / $78.88	Professional		$53.38	$64.45	$78.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.09 / $17.25 / $20.90	Professional	26	$16.09	$17.25	$20.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.13 / $44.88 / $59.95	Professional	TC	$36.13	$44.88	$59.95
HMSA Facility/Professional Professional Modifier Low / Median / High Price $17.61 / $64.25 / $82.49	Professional		$17.61	$64.25	$82.49
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $18.57 / $19.79 / $20.72	Professional	26	$18.57	$19.79	$20.72
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $56.74 / $59.41 / $61.77	Professional	TC	$56.74	$59.41	$61.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.27 / $70.12 / $81.80	Professional		$64.27	$70.12	$81.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.42 / $16.82 / $19.63	Professional	26	$15.42	$16.82	$19.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.85 / $53.29 / $56.40	Professional	TC	$48.85	$53.29	$56.40
United Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $78.88 / $87.71	Professional		$28.39	$78.88	$87.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $18.93 / $23.58	Professional	26	$8.55	$18.93	$23.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.84 / $59.95 / $64.13	Professional	TC	$19.84	$59.95	$64.13
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $71.19 / $87.14 / $126.13	Professional		$71.19	$87.14	$126.13
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $17.34 / $22.23 / $36.43	Professional	26	$17.34	$22.23	$36.43
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $50.58 / $66.02 / $89.70	Professional	TC	$50.58	$66.02	$89.70