Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.38 / $44.63 / $52.50	Facility		$39.38	$44.63	$52.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.72 / $9.88 / $11.62	Facility	26	$8.72	$9.88	$11.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.67 / $36.79 / $42.12	Facility	TC	$30.67	$36.79	$42.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $39.88 / $64.58	Professional		$33.50	$39.88	$64.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $11.85 / $62.04	Professional	26	$10.61	$11.85	$62.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $28.02 / $51.26	Professional	TC	$22.87	$28.02	$51.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.26 / $40.26 / $40.26	Facility		$40.26	$40.26	$40.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $30.58	Facility	TC	$30.58	$30.58	$30.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.33 / $43.70 / $58.34	Professional		$38.33	$43.70	$58.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $13.36 / $15.28	Professional	26	$9.88	$13.36	$15.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.97 / $29.34 / $41.75	Professional	TC	$24.97	$29.34	$41.75
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.85 / $41.09 / $56.25	Professional		$13.85	$41.09	$56.25
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.83 / $15.53 / $15.92	Professional	26	$14.83	$15.53	$15.92
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $38.89 / $40.72 / $40.72	Professional	TC	$38.89	$40.72	$40.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $46.67 / $54.45	Professional		$42.78	$46.67	$54.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $10.33 / $12.05	Professional	26	$9.47	$10.33	$12.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.32 / $36.35 / $38.47	Professional	TC	$33.32	$36.35	$38.47
United Facility/Professional Professional Modifier Low / Median / High Price $19.43 / $52.50 / $60.05	Professional		$19.43	$52.50	$60.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.88 / $11.62 / $16.35	Professional	26	$5.88	$11.62	$16.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.55 / $40.89 / $43.70	Professional	TC	$13.55	$40.89	$43.70
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $57.14 / $93.98	Professional		$39.61	$57.14	$93.98
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $14.17 / $26.82	Professional	26	$10.64	$14.17	$26.82
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $27.99 / $44.53 / $63.14	Professional	TC	$27.99	$44.53	$63.14