Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.11 / $12.59 / $14.81	Facility	26	$11.11	$12.59	$14.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.16 / $38.88 / $277.60	Facility	TC	$29.16	$38.88	$277.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $35.90 / $65.73	Professional		$30.19	$35.90	$65.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.31 / $14.81 / $28.20	Professional	26	$10.31	$14.81	$28.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $24.00 / $48.73	Professional	TC	$19.89	$24.00	$48.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $44.36 / $53.69	Professional		$36.72	$44.36	$53.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $13.33 / $16.10	Professional	26	$12.59	$13.33	$16.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.40 / $29.34 / $38.88	Professional	TC	$23.40	$29.34	$38.88
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.45 / $43.80 / $58.49	Professional		$13.45	$43.80	$58.49
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $15.08 / $15.46	Professional	26	$14.40	$15.08	$15.46
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $41.09 / $43.03	Professional	TC	$36.97	$41.09	$43.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.75 / $47.72 / $55.68	Professional		$43.75	$47.72	$55.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.07 / $13.16 / $15.36	Professional	26	$12.07	$13.16	$15.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.68 / $34.56 / $36.58	Professional	TC	$31.68	$34.56	$36.58
United Facility/Professional Professional Modifier Low / Median / High Price $19.70 / $53.69 / $60.29	Professional		$19.70	$53.69	$60.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.72 / $14.81 / $18.45	Professional	26	$6.72	$14.81	$18.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.98 / $38.88 / $41.84	Professional	TC	$12.98	$38.88	$41.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $48.36 / $59.71 / $85.56	Professional		$48.36	$59.71	$85.56
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $13.57 / $17.39 / $28.11	Professional	26	$13.57	$17.39	$28.11
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $32.46 / $42.85 / $57.43	Professional	TC	$32.46	$42.85	$57.43