Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.32 / $135.01 / $380.88	Facility		$43.32	$135.01	$380.88
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 $36.88 / $268.74 / $460.76	Facility	TC	$36.88	$268.74	$460.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $55.00 / $140.12	Professional		$36.65	$55.00	$140.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $14.87 / $37.34	Professional	26	$10.64	$14.87	$37.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.62 / $33.17 / $57.65	Professional	TC	$26.62	$33.17	$57.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.74 / $44.74 / $44.74	Facility		$44.74	$44.74	$44.74
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 $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.70 / $39.51 / $57.77	Professional		$26.70	$39.51	$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 $26.89 / $32.36 / $43.39	Professional	TC	$26.89	$32.36	$43.39
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $17.64 / $56.09	Professional		$13.05	$17.64	$56.09
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $14.97 / $15.35	Professional	26	$14.30	$14.97	$15.35
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $41.79 / $43.76 / $43.76	Professional	TC	$41.79	$43.76	$43.76
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 / $51.25 / $64.08	Professional		$20.84	$51.25	$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 $39.42 / $61.49 / $79.73	Professional		$39.42	$61.49	$79.73
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $16.30 / $23.72	Professional	26	$11.06	$16.30	$23.72
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $44.23 / $59.70	Professional	TC	$29.11	$44.23	$59.70