Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.93 / $47.92 / $289.85	Facility		$39.93	$47.92	$289.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.77 / $12.21 / $14.36	Facility	26	$10.77	$12.21	$14.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.87 / $35.61 / $59.18	Professional		$14.87	$35.61	$59.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $10.97 / $57.59	Professional	26	$9.41	$10.97	$57.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $40.57 / $40.82	Professional	TC	$19.76	$40.57	$40.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $41.01 / $41.01	Facility		$41.01	$41.01	$41.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.21 / $39.61 / $53.24	Professional		$34.21	$39.61	$53.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $12.45 / $15.62	Professional	26	$12.14	$12.45	$15.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.91 / $26.14 / $38.88	Professional	TC	$21.91	$26.14	$38.88
HMSA Facility/Professional Professional Modifier Low / Median / High Price $12.31 / $16.64 / $50.93	Professional		$12.31	$16.64	$50.93
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.13 / $14.48	Professional	26	$13.49	$14.13	$14.48
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $37.44 / $39.20 / $39.20	Professional	TC	$37.44	$39.20	$39.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.38 / $47.33 / $55.22	Professional		$43.38	$47.33	$55.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $12.77 / $14.90	Professional	26	$11.70	$12.77	$14.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.68 / $34.56 / $36.58	Professional	TC	$31.68	$34.56	$36.58
United Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $53.24 / $59.75	Professional		$19.50	$53.24	$59.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $17.91 / $87.90	Professional	26	$11.43	$17.91	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.98 / $38.88 / $41.84	Professional	TC	$12.98	$38.88	$41.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $35.84 / $54.43 / $85.68	Professional		$35.84	$54.43	$85.68
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $16.04 / $27.28	Professional	26	$10.61	$16.04	$27.28
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.09 / $42.34 / $58.40	Professional	TC	$26.09	$42.34	$58.40