Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.54 / $41.95 / $590.36	Facility		$33.54	$41.95	$590.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.68 / $8.71 / $10.25	Facility	26	$7.68	$8.71	$10.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.28 / $37.47 / $507.54	Facility	TC	$27.28	$37.47	$507.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.13 / $29.48 / $61.50	Professional		$11.13	$29.48	$61.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $8.71 / $16.73	Professional	26	$7.42	$8.71	$16.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.48 / $45.59	Professional	TC	$18.82	$23.48	$45.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.79 / $35.79 / $35.79	Facility		$35.79	$35.79	$35.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $35.15 / $46.62	Professional		$30.17	$35.15	$46.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.80 / $11.39	Professional	26	$8.71	$9.80	$11.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.25 / $24.76 / $36.36	Professional	TC	$20.25	$24.76	$36.36
HMSA Facility/Professional Professional Modifier Low / Median / High Price $10.03 / $41.94 / $47.72	Professional		$10.03	$41.94	$47.72
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $11.26 / $11.54	Professional	26	$10.75	$11.26	$11.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $34.54 / $36.18 / $36.18	Professional	TC	$34.54	$36.18	$36.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $41.44 / $48.34	Professional		$37.97	$41.44	$48.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.35 / $9.11 / $10.63	Professional	26	$8.35	$9.11	$10.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.63 / $32.33 / $34.21	Professional	TC	$29.63	$32.33	$34.21
United Facility/Professional Professional Modifier Low / Median / High Price $17.11 / $46.62 / $52.76	Professional		$17.11	$46.62	$52.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.88 / $10.25 / $13.40	Professional	26	$4.88	$10.25	$13.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.23 / $36.36 / $39.36	Professional	TC	$12.23	$36.36	$39.36
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $31.43 / $50.73 / $75.00	Professional		$31.43	$50.73	$75.00
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.05 / $20.39	Professional	26	$8.27	$12.05	$20.39
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $24.07 / $39.60 / $54.60	Professional	TC	$24.07	$39.60	$54.60