Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.65 / $41.50 / $287.20	Facility		$33.65	$41.50	$287.20
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 $26.90 / $35.86 / $345.10	Facility	TC	$26.90	$35.86	$345.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.25 / $36.04 / $76.28	Professional		$10.25	$36.04	$76.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $10.61 / $37.54	Professional	26	$7.61	$10.61	$37.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.62 / $112.62 / $112.62	Professional	50	$112.62	$112.62	$112.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $21.93 / $40.22	Professional	TC	$17.57	$21.93	$40.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $35.40 / $35.40	Facility		$35.40	$35.40	$35.40
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 $26.85 / $26.85 / $26.85	Facility	TC	$26.85	$26.85	$26.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.84 / $32.85 / $46.12	Professional		$29.84	$32.85	$46.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.72 / $11.39	Professional	26	$8.71	$9.72	$11.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.25 / $22.45 / $35.86	Professional	TC	$20.25	$22.45	$35.86
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.81 / $37.81 / $47.20	Professional		$9.81	$37.81	$47.20
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 $34.06 / $35.65 / $35.65	Professional	TC	$34.06	$35.65	$35.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.58 / $40.99 / $47.82	Professional		$37.58	$40.99	$47.82
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 $29.23 / $31.88 / $33.74	Professional	TC	$29.23	$31.88	$33.74
United Facility/Professional Professional Modifier Low / Median / High Price $16.73 / $46.12 / $51.53	Professional		$16.73	$46.12	$51.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.69 / $10.25 / $12.78	Professional	26	$4.69	$10.25	$12.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.04 / $35.86 / $38.75	Professional	TC	$12.04	$35.86	$38.75
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $50.19 / $74.06	Professional		$30.70	$50.19	$74.06
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $11.96 / $20.39	Professional	26	$8.27	$11.96	$20.39
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $23.55 / $37.53 / $53.64	Professional	TC	$23.55	$37.53	$53.64