Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $48.98 / $363.08	Facility		$36.31	$48.98	$363.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $11.75 / $13.80	Facility	26	$10.47	$11.75	$13.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $36.31 / $302.00	Facility	TC	$26.30	$36.31	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $44.67 / $169.82	Professional		$27.54	$44.67	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $57.54	Professional	26	$8.91	$14.13	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.70 / $64.57	Professional	TC	$15.85	$25.70	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $40.74 / $64.57	Professional		$24.55	$40.74	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.49 / $22.91	Professional	26	$8.71	$13.49	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $26.92 / $41.69	Professional	TC	$15.85	$26.92	$41.69
HMSA Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $48.98	Professional		$30.90	$46.77	$48.98
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $13.80 / $14.45	Professional	26	$13.49	$13.80	$14.45
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $34.67	Professional	TC	$33.11	$33.11	$34.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $43.65 / $51.29	Professional		$39.81	$43.65	$51.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.30 / $14.45	Professional	26	$11.22	$12.30	$14.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $30.90 / $36.31	Professional	TC	$28.84	$30.90	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $44.67 / $66.07	Professional		$38.90	$44.67	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $21.38	Professional	26	$12.02	$15.14	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.84 / $43.65	Professional	TC	$26.92	$28.84	$43.65
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $77.62	Professional		$42.66	$53.70	$77.62
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.85 / $26.30	Professional	26	$12.59	$15.85	$26.30
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.02 / $51.29	Professional	TC	$28.18	$38.02	$51.29