Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.97 / $6.66 / $131.00	Professional	26	$5.97	$6.66	$131.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.44 / $22.58 / $143.50	Professional	TC	$19.44	$22.58	$143.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $26.79 / $41.77	Professional	26	$20.78	$26.79	$41.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.03 / $88.28 / $133.29	Professional	TC	$66.03	$88.28	$133.29
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $26.20 / $27.43 / $28.13	Professional	26	$26.20	$27.43	$28.13
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $95.09 / $97.13 / $99.57	Professional	TC	$95.09	$97.13	$99.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.72 / $29.09 / $33.94	Professional	26	$24.72	$29.09	$33.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $86.42 / $101.68 / $118.62	Professional	TC	$86.42	$101.68	$118.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.82 / $30.30 / $31.83	Professional	26	$21.82	$30.30	$31.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.42 / $105.91 / $105.91	Professional	TC	$86.42	$105.91	$105.91
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $26.11 / $26.11 / $26.11	Professional	26	$26.11	$26.11	$26.11
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $91.51 / $91.51 / $91.51	Professional	TC	$91.51	$91.51	$91.51