Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.14 / $59.57 / $324.11	Facility		$42.14	$59.57	$324.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.77 / $12.21 / $14.36	Facility	26	$10.77	$12.21	$14.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.54 / $43.39 / $294.39	Facility	TC	$32.54	$43.39	$294.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.11 / $53.92 / $169.66	Professional		$35.11	$53.92	$169.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.48 / $14.87 / $21.87	Professional	26	$9.48	$14.87	$21.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $31.24 / $54.42	Professional	TC	$25.05	$31.24	$54.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.36 / $44.36 / $44.36	Facility		$44.36	$44.36	$44.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.70 / $37.44 / $57.77	Professional		$26.70	$37.44	$57.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $12.62 / $15.96	Professional	26	$12.14	$12.62	$15.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.20 / $31.17 / $43.39	Professional	TC	$24.20	$31.17	$43.39
HMSA Facility/Professional Professional Modifier Low / Median / High Price $12.31 / $16.64 / $54.80	Professional		$12.31	$16.64	$54.80
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.13 / $14.48	Professional	26	$13.49	$14.13	$14.48
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $41.31 / $43.26 / $43.26	Professional	TC	$41.31	$43.26	$43.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.07 / $51.35 / $59.91	Professional		$47.07	$51.35	$59.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $12.77 / $14.90	Professional	26	$11.70	$12.77	$14.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.35 / $38.57 / $40.82	Professional	TC	$35.35	$38.57	$40.82
United Facility/Professional Professional Modifier Low / Median / High Price $20.84 / $57.77 / $64.08	Professional		$20.84	$57.77	$64.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $14.36 / $17.91	Professional	26	$6.52	$14.36	$17.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.32 / $43.39 / $46.17	Professional	TC	$14.32	$43.39	$46.17
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $62.86 / $75.64	Professional		$39.75	$62.86	$75.64
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $15.89 / $23.72	Professional	26	$10.08	$15.89	$23.72
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $28.78 / $47.25 / $55.58	Professional	TC	$28.78	$47.25	$55.58