Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $75.86 / $128.82	Professional		$56.23	$75.86	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $30.90 / $38.90	Professional	26	$19.50	$30.90	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $43.65 / $89.13	Professional	TC	$36.31	$43.65	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $112.20	Professional		$26.30	$31.62	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $13.49 / $30.90	Professional	26	$12.88	$13.49	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $17.38 / $83.18	Professional	TC	$13.18	$17.38	$83.18
HMSA Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $107.15 / $112.20	Professional		$45.71	$107.15	$112.20
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $37.15 / $53.70	Professional	26	$35.48	$37.15	$53.70
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $58.88 / $69.18	Professional	TC	$56.23	$58.88	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $109.65 / $128.82	Professional		$100.00	$109.65	$128.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $30.20 / $34.67	Professional	26	$27.54	$30.20	$34.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $79.43 / $93.33	Professional	TC	$72.44	$79.43	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $37.15 / $114.82	Professional		$31.62	$37.15	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $16.22 / $41.69	Professional	26	$15.14	$16.22	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.39 / $83.18	Professional	TC	$15.49	$22.39	$83.18
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $100.00 / $134.90	Professional		$60.26	$100.00	$134.90
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $36.31 / $47.86	Professional	26	$26.92	$36.31	$47.86
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $63.10 / $97.72	Professional	TC	$30.90	$63.10	$97.72