Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.58 / $38.33 / $259.25	Facility		$29.58	$38.33	$259.25
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 $24.27 / $32.36 / $555.20	Facility	TC	$24.27	$32.36	$555.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.25 / $30.93 / $52.26	Professional		$10.25	$30.93	$52.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $10.25 / $17.18	Professional	26	$7.42	$10.25	$17.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $22.70 / $40.54	Professional	TC	$18.21	$22.70	$40.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $32.79 / $32.79	Facility		$32.79	$32.79	$32.79
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 $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $32.86 / $44.73	Professional		$29.05	$32.86	$44.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.22 / $11.39	Professional	26	$8.71	$9.22	$11.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $23.37 / $33.03	Professional	TC	$19.82	$23.37	$33.03
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.02 / $37.81 / $42.75	Professional		$9.02	$37.81	$42.75
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $9.89 / $10.36 / $10.62	Professional	26	$9.89	$10.36	$10.62
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $30.68 / $32.13 / $32.13	Professional	TC	$30.68	$32.13	$32.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $37.86 / $44.17	Professional		$34.71	$37.86	$44.17
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 $26.37 / $28.76 / $30.44	Professional	TC	$26.37	$28.76	$30.44
United Facility/Professional Professional Modifier Low / Median / High Price $29.03 / $48.43 / $212.23	Professional		$29.03	$48.43	$212.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.88 / $10.40 / $13.40	Professional	26	$4.88	$10.40	$13.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.89 / $26.10 / $35.03	Professional	TC	$10.89	$26.10	$35.03
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $28.35 / $46.23 / $66.47	Professional		$28.35	$46.23	$66.47
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $11.61 / $17.73	Professional	26	$7.12	$11.61	$17.73
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $34.40 / $43.02	Professional	TC	$21.38	$34.40	$43.02