Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $38.90 / $281.84	Facility		$33.88	$38.90	$281.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $9.55 / $11.22	Facility	26	$8.32	$9.55	$11.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $36.31 / $371.54	Facility	TC	$27.54	$36.31	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $38.90 / $173.78	Professional		$12.88	$38.90	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $46.77	Professional	26	$7.08	$12.02	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.84 / $114.82	Professional	TC	$16.98	$28.84	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $41.69 / $66.07	Professional		$29.51	$41.69	$66.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $18.62	Professional	26	$6.92	$10.47	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.20 / $47.86	Professional	TC	$22.39	$30.20	$47.86
HMSA Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $48.98	Professional		$33.88	$47.86	$48.98
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $10.96 / $11.48	Professional	26	$10.72	$10.96	$11.48
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $35.48 / $37.15	Professional	TC	$34.67	$35.48	$37.15
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 $9.33 / $10.23 / $12.02	Professional	26	$9.33	$10.23	$12.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $33.88 / $38.90	Professional	TC	$30.90	$33.88	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $45.71 / $63.10	Professional		$38.90	$45.71	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.22 / $16.98	Professional	26	$9.77	$11.22	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.11 / $44.67	Professional	TC	$28.84	$33.11	$44.67
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $72.44	Professional		$36.31	$51.29	$72.44
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.59 / $18.62	Professional	26	$9.33	$12.59	$18.62
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $39.81 / $54.95	Professional	TC	$28.18	$39.81	$54.95