Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.40 / $42.79 / $334.80	Facility		$34.40	$42.79	$334.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.38 / $9.50 / $11.18	Facility	26	$8.38	$9.50	$11.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.91 / $233.97 / $369.00	Facility	TC	$30.91	$233.97	$369.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.54 / $49.05 / $153.50	Professional		$11.54	$49.05	$153.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $11.58 / $28.48	Professional	26	$8.09	$11.58	$28.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $37.67 / $50.90	Professional	TC	$23.51	$37.67	$50.90
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 $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.71 / $38.47 / $52.83	Professional		$32.71	$38.47	$52.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $9.92 / $12.17	Professional	26	$9.50	$9.92	$12.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.05 / $26.75 / $40.40	Professional	TC	$23.05	$26.75	$40.40
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.81 / $43.18 / $48.64	Professional		$9.81	$43.18	$48.64
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $11.26 / $11.54	Professional	26	$10.75	$11.26	$11.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $34.54 / $36.18 / $37.10	Professional	TC	$34.54	$36.18	$37.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.74 / $42.26 / $49.31	Professional		$38.74	$42.26	$49.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $9.94 / $11.59	Professional	26	$9.11	$9.94	$11.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.63 / $32.33 / $34.21	Professional	TC	$29.63	$32.33	$34.21
United Facility/Professional Professional Modifier Low / Median / High Price $16.93 / $47.55 / $52.07	Professional		$16.93	$47.55	$52.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.09 / $11.18 / $13.94	Professional	26	$5.09	$11.18	$13.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.84 / $36.36 / $38.13	Professional	TC	$11.84	$36.36	$38.13
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.03 / $51.02 / $81.54	Professional		$36.03	$51.02	$81.54
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.48 / $21.23	Professional	26	$8.27	$12.48	$21.23
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.40 / $37.36 / $60.28	Professional	TC	$26.40	$37.36	$60.28