Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.89 / $197.12 / $360.45	Facility		$35.89	$197.12	$360.45
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.74 / $11.04 / $12.99	Facility	26	$9.74	$11.04	$12.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.15 / $34.86 / $319.83	Facility	TC	$26.15	$34.86	$319.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $45.15 / $58.62	Professional		$30.73	$45.15	$58.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $13.45 / $33.77	Professional	26	$9.73	$13.45	$33.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $26.19 / $43.05	Professional	TC	$21.01	$26.19	$43.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.90 / $36.90 / $36.90	Facility		$36.90	$36.90	$36.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $38.27 / $53.18	Professional		$26.25	$38.27	$53.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $12.45 / $14.43	Professional	26	$11.04	$12.45	$14.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $26.13 / $37.93	Professional	TC	$22.74	$26.13	$37.93
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.03 / $31.35 / $48.96	Professional		$13.03	$31.35	$48.96
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 $33.26 / $34.83 / $34.83	Professional	TC	$33.26	$34.83	$34.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $42.54 / $49.63	Professional		$39.00	$42.54	$49.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $11.54 / $13.47	Professional	26	$10.58	$11.54	$13.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.41 / $31.00 / $32.79	Professional	TC	$28.41	$31.00	$32.79
United Facility/Professional Professional Modifier Low / Median / High Price $17.37 / $47.86 / $53.09	Professional		$17.37	$47.86	$53.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.91 / $12.99 / $16.20	Professional	26	$5.91	$12.99	$16.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.46 / $34.86 / $36.89	Professional	TC	$11.46	$34.86	$36.89
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $53.49 / $76.76	Professional		$36.01	$53.49	$76.76
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $15.76 / $26.65	Professional	26	$10.61	$15.76	$26.65
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $25.39 / $38.72 / $54.56	Professional	TC	$25.39	$38.72	$54.56