Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.79 / $14.49 / $17.05	Facility	26	$12.79	$14.49	$17.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.68 / $38.17 / $44.90	Facility	TC	$33.68	$38.17	$44.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $41.89 / $75.87	Professional		$35.22	$41.89	$75.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $13.93 / $19.55	Professional	26	$12.06	$13.93	$19.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $27.96 / $56.30	Professional	TC	$23.17	$27.96	$56.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.92 / $33.92 / $33.92	Facility	TC	$33.92	$33.92	$33.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.90 / $51.83 / $61.95	Professional		$42.90	$51.83	$61.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $15.65 / $18.86	Professional	26	$14.49	$15.65	$18.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.26 / $34.09 / $44.90	Professional	TC	$27.26	$34.09	$44.90
HMSA Facility/Professional Professional Modifier Low / Median / High Price $15.19 / $45.45 / $66.90	Professional		$15.19	$45.45	$66.90
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $17.45 / $17.87	Professional	26	$16.66	$17.45	$17.87
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $43.71 / $46.82 / $49.03	Professional	TC	$43.71	$46.82	$49.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.48 / $55.07 / $64.25	Professional		$50.48	$55.07	$64.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.89 / $15.16 / $17.68	Professional	26	$13.89	$15.16	$17.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.59 / $39.90 / $42.24	Professional	TC	$36.59	$39.90	$42.24
United Facility/Professional Professional Modifier Low / Median / High Price $22.83 / $61.95 / $69.90	Professional		$22.83	$61.95	$69.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $17.05 / $21.24	Professional	26	$7.75	$17.05	$21.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.08 / $44.90 / $48.66	Professional	TC	$15.08	$44.90	$48.66
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $56.87 / $71.72 / $99.82	Professional		$56.87	$71.72	$99.82
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $15.62 / $20.02 / $32.89	Professional	26	$15.62	$20.02	$32.89
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $50.42 / $66.93	Professional	TC	$40.74	$50.42	$66.93