Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $30.20 / $42.66	Facility		$26.92	$30.20	$42.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $9.55 / $11.22	Facility	26	$8.32	$9.55	$11.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $26.30 / $30.90	Facility	TC	$21.88	$26.30	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $34.67 / $144.54	Professional		$21.38	$34.67	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.96 / $48.98	Professional	26	$6.92	$10.96	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $19.95 / $45.71	Professional	TC	$14.13	$19.95	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $67.61	Professional		$22.91	$34.67	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.72 / $18.62	Professional	26	$7.59	$10.72	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $20.89 / $48.98	Professional	TC	$15.49	$20.89	$48.98
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $38.90 / $40.74	Professional		$13.18	$38.90	$40.74
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $10.96 / $11.48	Professional	26	$10.72	$10.96	$11.48
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $27.54 / $28.84	Professional	TC	$27.54	$27.54	$28.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $37.15 / $42.66	Professional		$33.88	$37.15	$42.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.23 / $12.02	Professional	26	$9.33	$10.23	$12.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $26.92 / $30.90	Professional	TC	$24.55	$26.92	$30.90
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $57.54	Professional		$32.36	$40.74	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.22 / $16.98	Professional	26	$9.77	$11.22	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $39.81	Professional	TC	$22.91	$29.51	$39.81
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $72.44	Professional		$32.36	$44.67	$72.44
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.59 / $18.62	Professional	26	$9.55	$12.59	$18.62
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $53.70	Professional	TC	$21.88	$32.36	$53.70