Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.96 / $47.54 / $390.91	Facility		$39.96	$47.54	$390.91
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 $34.43 / $45.90 / $479.70	Facility	TC	$34.43	$45.90	$479.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $57.44 / $74.08	Professional		$35.95	$57.44	$74.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $14.36 / $16.52	Professional	26	$10.36	$14.36	$16.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $30.22 / $57.56	Professional	TC	$25.57	$30.22	$57.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.23 / $46.23 / $46.23	Facility		$46.23	$46.23	$46.23
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 $34.29 / $34.29 / $34.29	Facility	TC	$34.29	$34.29	$34.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.25 / $49.90 / $60.28	Professional		$43.25	$49.90	$60.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.21 / $13.29 / $15.96	Professional	26	$12.21	$13.29	$15.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.96 / $35.50 / $45.90	Professional	TC	$29.96	$35.50	$45.90
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.66 / $53.98 / $63.64	Professional		$13.66	$53.98	$63.64
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $15.35 / $16.07	Professional	26	$14.40	$15.35	$16.07
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $43.71 / $45.77 / $47.57	Professional	TC	$43.71	$45.77	$47.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.12 / $53.58 / $62.51	Professional		$49.12	$53.58	$62.51
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 $37.40 / $40.79 / $43.18	Professional	TC	$37.40	$40.79	$43.18
United Facility/Professional Professional Modifier Low / Median / High Price $21.79 / $60.28 / $67.17	Professional		$21.79	$60.28	$67.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $16.26 / $17.96	Professional	26	$6.52	$16.26	$17.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.27 / $45.90 / $49.26	Professional	TC	$15.27	$45.90	$49.26
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $67.02 / $97.06	Professional		$55.33	$67.02	$97.06
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $17.19 / $27.28	Professional	26	$13.16	$17.19	$27.28
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $41.94 / $50.98 / $69.78	Professional	TC	$41.94	$50.98	$69.78