Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.51 / $44.20 / $268.69	Facility		$36.51	$44.20	$268.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.72 / $9.88 / $11.62	Facility	26	$8.72	$9.88	$11.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.28 / $36.34 / $306.39	Facility	TC	$30.28	$36.34	$306.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.04 / $34.50 / $119.80	Professional		$12.04	$34.50	$119.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $12.04 / $36.39	Professional	26	$8.46	$12.04	$36.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $24.79 / $50.63	Professional	TC	$20.96	$24.79	$50.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $39.89 / $39.89	Facility		$39.89	$39.89	$39.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	TC	$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.42 / $42.85 / $52.00	Professional		$35.42	$42.85	$52.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $10.86 / $12.92	Professional	26	$9.88	$10.86	$12.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.56 / $30.64 / $40.38	Professional	TC	$24.56	$30.64	$40.38
HMSA Facility/Professional Professional Modifier Low / Median / High Price $11.12 / $43.63 / $54.36	Professional		$11.12	$43.63	$54.36
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $11.71 / $12.49 / $13.08	Professional	26	$11.71	$12.49	$13.08
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $37.93 / $39.72 / $41.28	Professional	TC	$37.93	$39.72	$41.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.37 / $46.22 / $53.93	Professional		$42.37	$46.22	$53.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $10.33 / $12.05	Professional	26	$9.47	$10.33	$12.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.90 / $35.89 / $37.99	Professional	TC	$32.90	$35.89	$37.99
United Facility/Professional Professional Modifier Low / Median / High Price $18.86 / $47.55 / $58.19	Professional		$18.86	$47.55	$58.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.31 / $11.62 / $14.49	Professional	26	$5.31	$11.62	$14.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.55 / $40.38 / $43.70	Professional	TC	$13.55	$40.38	$43.70
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.74 / $58.55 / $85.22	Professional		$47.74	$58.55	$85.22
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $14.01 / $23.02	Professional	26	$10.95	$14.01	$23.02
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $37.00 / $44.85 / $62.19	Professional	TC	$37.00	$44.85	$62.19