Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.70 / $7.60 / $8.94	Facility	26	$6.70	$7.60	$8.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.56 / $47.41 / $212.80	Facility	TC	$35.56	$47.41	$212.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.22 / $41.73 / $127.70	Professional		$9.22	$41.73	$127.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $9.26 / $27.00	Professional	26	$6.21	$9.26	$27.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.57 / $12.57 / $12.57	Professional	52	$12.57	$12.57	$12.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $46.24 / $52.63	Professional	TC	$22.57	$46.24	$52.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.96 / $35.40 / $56.34	Professional		$23.96	$35.40	$56.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $7.68 / $9.74	Professional	26	$7.23	$7.68	$9.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.73 / $27.72 / $47.41	Professional	TC	$16.73	$27.72	$47.41
HMSA Facility/Professional Professional Modifier Low / Median / High Price $7.96 / $32.31 / $62.60	Professional		$7.96	$32.31	$62.60
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $8.72 / $9.13 / $9.36	Professional	26	$8.72	$9.13	$9.36
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $44.20 / $50.84 / $53.24	Professional	TC	$44.20	$50.84	$53.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.90 / $50.08 / $58.42	Professional		$45.90	$50.08	$58.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $7.94 / $9.27	Professional	26	$7.28	$7.94	$9.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.63 / $42.14 / $44.60	Professional	TC	$38.63	$42.14	$44.60
United Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $45.94 / $60.43	Professional		$19.34	$45.94	$60.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.07 / $8.94 / $11.15	Professional	26	$4.07	$8.94	$11.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.27 / $47.41 / $49.28	Professional	TC	$15.27	$47.41	$49.28
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $52.36 / $83.90	Professional		$33.97	$52.36	$83.90
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $9.94 / $16.97	Professional	26	$6.62	$9.94	$16.97
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $24.43 / $43.48 / $66.93	Professional	TC	$24.43	$43.48	$66.93