Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.20 / $41.04 / $586.50	Facility		$34.20	$41.04	$586.50
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 $26.15 / $31.38 / $34.86	Facility	TC	$26.15	$31.38	$34.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.13 / $30.54 / $47.52	Professional		$11.13	$30.54	$47.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $11.13 / $22.26	Professional	26	$7.03	$11.13	$22.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.53 / $10.53 / $10.53	Professional	52	$10.53	$10.53	$10.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.92 / $127.10	Professional	TC	$17.89	$21.92	$127.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $35.40 / $35.40	Facility		$35.40	$35.40	$35.40
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 $26.47 / $26.47 / $26.47	Facility	TC	$26.47	$26.47	$26.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.29 / $32.40 / $45.60	Professional		$28.29	$32.40	$45.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $9.22 / $11.70	Professional	26	$8.86	$9.22	$11.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $22.91 / $34.86	Professional	TC	$19.43	$22.91	$34.86
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.64 / $35.69 / $45.74	Professional		$9.64	$35.69	$45.74
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.32 / $10.81 / $11.08	Professional	26	$10.32	$10.81	$11.08
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $33.10 / $34.65 / $34.65	Professional	TC	$33.10	$34.65	$34.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $40.54 / $47.29	Professional		$37.15	$40.54	$47.29
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 $28.41 / $31.00 / $32.79	Professional	TC	$28.41	$31.00	$32.79
United Facility/Professional Professional Modifier Low / Median / High Price $16.54 / $38.13 / $50.92	Professional		$16.54	$38.13	$50.92
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 $11.66 / $34.86 / $37.52	Professional	TC	$11.66	$34.86	$37.52
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.37 / $49.63 / $71.22	Professional		$30.37	$49.63	$71.22
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.93 / $20.39	Professional	26	$7.94	$11.93	$20.39
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $22.23 / $37.53 / $49.47	Professional	TC	$22.23	$37.53	$49.47