Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $69.18 / $87.10	Professional		$41.69	$69.18	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.18 / $79.43	Professional	26	$20.89	$28.18	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $39.81 / $60.26	Professional	TC	$28.18	$39.81	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $85.11	Professional		$43.65	$57.54	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $25.12 / $29.51	Professional	26	$17.38	$25.12	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $32.36 / $43.65	Professional	TC	$25.70	$32.36	$43.65
HMSA Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $97.72 / $114.82	Professional		$37.15	$97.72	$114.82
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $37.15 / $38.02	Professional	26	$35.48	$37.15	$38.02
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $74.13 / $77.62	Professional	TC	$61.66	$74.13	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $104.71	Professional		$77.62	$77.62	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $41.69	Professional	26	$30.20	$30.20	$41.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $63.10	Professional	TC	$46.77	$46.77	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $69.18 / $93.33	Professional		$43.65	$69.18	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $27.54 / $41.69	Professional	26	$19.50	$27.54	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $41.69 / $52.48	Professional	TC	$23.99	$41.69	$52.48
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $81.28 / $87.10	Professional		$48.98	$81.28	$87.10
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.84 / $36.31	Professional	26	$20.89	$28.84	$36.31
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $46.77 / $51.29	Professional	TC	$28.84	$46.77	$51.29