Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $45.71 / $53.70	Facility		$39.81	$45.71	$53.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $12.30 / $14.45	Facility	26	$10.72	$12.30	$14.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.90 / $158.49	Professional		$22.91	$38.90	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $61.66	Professional	26	$7.94	$14.13	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.92 / $48.98	Professional	TC	$16.98	$26.92	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $70.79	Professional		$28.18	$40.74	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $23.44	Professional	26	$8.91	$13.18	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.30 / $46.77	Professional	TC	$19.05	$26.30	$46.77
HMSA Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $51.29 / $53.70	Professional		$33.11	$51.29	$53.70
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $13.80 / $14.45	Professional	26	$13.49	$13.80	$14.45
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $38.90	Professional	TC	$37.15	$37.15	$38.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $47.86 / $54.95	Professional		$43.65	$47.86	$54.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.88 / $14.79	Professional	26	$11.75	$12.88	$14.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $34.67 / $40.74	Professional	TC	$31.62	$34.67	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $47.86 / $72.44	Professional		$42.66	$47.86	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.45 / $21.38	Professional	26	$12.02	$14.45	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $31.62 / $48.98	Professional	TC	$29.51	$31.62	$48.98
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $56.23 / $74.13	Professional		$38.02	$56.23	$74.13
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $23.99	Professional	26	$12.02	$15.85	$23.99
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $42.66 / $51.29	Professional	TC	$26.30	$42.66	$51.29