Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.89 / $40.18 / $75.02	Facility		$34.89	$40.18	$75.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.06 / $9.13 / $10.75	Facility	26	$8.06	$9.13	$10.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.79 / $38.38 / $313.20	Facility	TC	$28.79	$38.38	$313.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.62 / $35.94 / $60.46	Professional		$11.62	$35.94	$60.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.66 / $30.79	Professional	26	$7.66	$9.66	$30.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.28 / $11.43 / $11.62	Professional	52	$11.28	$11.43	$11.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $24.59 / $48.12	Professional	TC	$20.07	$24.59	$48.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Facility		$38.02	$38.02	$38.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.60 / $33.11 / $51.39	Professional		$20.60	$33.11	$51.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $9.53 / $11.94	Professional	26	$8.86	$9.53	$11.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $24.29 / $38.47	Professional	TC	$19.43	$24.29	$38.47
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.73 / $35.69 / $54.73	Professional		$9.73	$35.69	$54.73
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.66 / $11.16 / $11.45	Professional	26	$10.66	$11.16	$11.45
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $41.33 / $43.28	Professional	TC	$36.97	$41.33	$43.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.03 / $43.67 / $50.95	Professional		$40.03	$43.67	$50.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.76 / $9.55 / $11.14	Professional	26	$8.76	$9.55	$11.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.27 / $34.11 / $36.11	Professional	TC	$31.27	$34.11	$36.11
United Facility/Professional Professional Modifier Low / Median / High Price $17.87 / $49.13 / $55.25	Professional		$17.87	$49.13	$55.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.88 / $10.75 / $13.40	Professional	26	$4.88	$10.75	$13.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.99 / $30.72 / $41.85	Professional	TC	$12.99	$30.72	$41.85
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.06 / $53.29 / $79.38	Professional		$33.06	$53.29	$79.38
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $8.76 / $12.35 / $21.37	Professional	26	$8.76	$12.35	$21.37
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $25.39 / $39.61 / $57.62	Professional	TC	$25.39	$39.61	$57.62