Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.23 / $46.73 / $54.97	Facility		$41.23	$46.73	$54.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.20 / $14.96 / $17.60	Facility	26	$13.20	$14.96	$17.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $35.97 / $66.81	Professional		$30.69	$35.97	$66.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.31 / $14.52 / $73.76	Professional	26	$2.31	$14.52	$73.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $20.29 / $46.85	Professional	TC	$17.89	$20.29	$46.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $42.87	Facility		$42.87	$42.87	$42.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.64 / $46.73 / $61.08	Professional		$29.64	$46.73	$61.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.98 / $17.60 / $20.61	Professional	26	$10.98	$17.60	$20.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $30.22 / $41.52	Professional	TC	$17.32	$30.22	$41.52
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.88 / $31.45 / $60.07	Professional		$18.88	$31.45	$60.07
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $20.21 / $21.16 / $21.70	Professional	26	$20.21	$21.16	$21.70
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $38.90 / $41.11	Professional	TC	$37.15	$38.90	$41.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.79 / $48.86 / $57.01	Professional		$44.79	$48.86	$57.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $15.65 / $18.26	Professional	26	$14.34	$15.65	$18.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.45 / $33.22 / $38.75	Professional	TC	$30.45	$33.22	$38.75
United Facility/Professional Professional Modifier Low / Median / High Price $41.23 / $54.97 / $61.01	Professional		$41.23	$54.97	$61.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $17.60 / $22.61	Professional	26	$13.87	$17.60	$22.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $31.76 / $38.40	Professional	TC	$22.37	$31.76	$38.40
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $37.28 / $59.81 / $79.97	Professional		$37.28	$59.81	$79.97
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $14.37 / $20.76 / $34.43	Professional	26	$14.37	$20.76	$34.43
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $22.06 / $36.34 / $48.93	Professional	TC	$22.06	$36.34	$48.93