Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.09 / $238.78 / $347.26	Facility		$28.09	$238.78	$347.26
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 $21.96 / $254.40 / $273.60	Facility	TC	$21.96	$254.40	$273.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $21.06 / $45.67	Professional		$17.78	$21.06	$45.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $11.01 / $34.00	Professional	26	$8.14	$11.01	$34.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $11.72 / $32.35	Professional	TC	$9.69	$11.72	$32.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.01 / $29.01 / $29.01	Facility		$29.01	$29.01	$29.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.92 / $26.10 / $37.45	Professional		$21.92	$26.10	$37.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $10.47 / $12.65	Professional	26	$9.88	$10.47	$12.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.45 / $14.52 / $25.84	Professional	TC	$11.45	$14.52	$25.84
HMSA Facility/Professional Professional Modifier Low / Median / High Price $10.24 / $13.86 / $36.90	Professional		$10.24	$13.86	$36.90
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $11.76 / $12.05	Professional	26	$11.23	$11.76	$12.05
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $24.02 / $25.15 / $25.15	Professional	TC	$24.02	$25.15	$25.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $33.29 / $38.84	Professional		$30.51	$33.29	$38.84
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 $21.05 / $22.97 / $24.31	Professional	TC	$21.05	$22.97	$24.31
United Facility/Professional Professional Modifier Low / Median / High Price $25.78 / $42.71 / $87.90	Professional		$25.78	$42.71	$87.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.30 / $11.62 / $15.09	Professional	26	$5.30	$11.62	$15.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.78 / $25.84 / $28.22	Professional	TC	$8.78	$25.84	$28.22
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $27.23 / $38.11 / $50.09	Professional		$27.23	$38.11	$50.09
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $13.47 / $22.08	Professional	26	$10.64	$13.47	$22.08
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $17.01 / $24.22 / $31.50	Professional	TC	$17.01	$24.22	$31.50