Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.32 / $7.16 / $8.42	Facility	26	$6.32	$7.16	$8.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.39 / $30.47 / $235.20	Facility	TC	$25.39	$30.47	$235.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.74 / $44.14 / $152.29	Professional		$8.74	$44.14	$152.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $8.42 / $11.32	Professional	26	$5.53	$8.42	$11.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $26.62 / $43.87	Professional	TC	$21.01	$26.62	$43.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $30.52 / $47.00	Professional		$17.43	$30.52	$47.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $7.53 / $9.19	Professional	26	$7.16	$7.53	$9.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.73 / $24.40 / $37.61	Professional	TC	$16.73	$24.40	$37.61
HMSA Facility/Professional Professional Modifier Low / Median / High Price $7.32 / $31.15 / $47.90	Professional		$7.32	$31.15	$47.90
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $8.40 / $8.61	Professional	26	$8.02	$8.40	$8.61
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $32.61 / $37.52 / $39.29	Professional	TC	$32.61	$37.52	$39.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.46 / $37.60 / $43.86	Professional		$34.46	$37.60	$43.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.86 / $7.49 / $8.74	Professional	26	$6.86	$7.49	$8.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.59 / $30.10 / $31.85	Professional	TC	$27.59	$30.10	$31.85
United Facility/Professional Professional Modifier Low / Median / High Price $15.34 / $42.30 / $47.42	Professional		$15.34	$42.30	$47.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.88 / $8.42 / $10.53	Professional	26	$3.88	$8.42	$10.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.46 / $33.86 / $36.89	Professional	TC	$11.46	$33.86	$36.89
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $28.47 / $47.14 / $73.45	Professional		$28.47	$47.14	$73.45
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $6.24 / $9.55 / $16.03	Professional	26	$6.24	$9.55	$16.03
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $22.73 / $36.86 / $57.43	Professional	TC	$22.73	$36.86	$57.43