Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.61 / $52.34 / $65.84	Facility		$30.61	$52.34	$65.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $8.27 / $9.75	Facility	26	$7.31	$8.27	$9.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.51 / $26.64 / $31.35	Facility	TC	$23.51	$26.64	$31.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.18 / $34.89 / $84.80	Professional		$20.18	$34.89	$84.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $10.09 / $20.18	Professional	26	$6.71	$10.09	$20.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.61 / $9.61 / $9.61	Professional	52	$9.61	$9.61	$9.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.92 / $39.29	Professional	TC	$17.89	$21.92	$39.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.07 / $32.07 / $32.07	Facility		$32.07	$32.07	$32.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $8.51	Facility	26	$8.51	$8.51	$8.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.71 / $29.05 / $44.18	Professional		$22.71	$29.05	$44.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $8.88 / $10.61	Professional	26	$8.27	$8.88	$10.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $22.00 / $33.57	Professional	TC	$19.43	$22.00	$33.57
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.42 / $35.69 / $42.20	Professional		$9.42	$35.69	$42.20
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.32 / $10.81 / $11.08	Professional	26	$10.32	$10.81	$11.08
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $29.72 / $31.12 / $31.12	Professional	TC	$29.72	$31.12	$31.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $36.53 / $42.62	Professional		$33.47	$36.53	$42.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.66 / $10.11	Professional	26	$7.94	$8.66	$10.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $27.86 / $29.49	Professional	TC	$25.54	$27.86	$29.49
United Facility/Professional Professional Modifier Low / Median / High Price $15.20 / $41.09 / $46.58	Professional		$15.20	$41.09	$46.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.50 / $9.75 / $12.17	Professional	26	$4.50	$9.75	$12.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.13 / $31.35 / $34.40	Professional	TC	$20.13	$31.35	$34.40
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.26 / $45.66 / $67.41	Professional		$29.26	$45.66	$67.41
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $11.31 / $18.52	Professional	26	$7.20	$11.31	$18.52
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $22.06 / $34.40 / $48.90	Professional	TC	$22.06	$34.40	$48.90