Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $46.77 / $128.82	Facility		$40.74	$46.77	$128.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $12.30 / $14.45	Facility	26	$10.72	$12.30	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.67 / $41.69 / $134.90	Facility	TC	$34.67	$41.69	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $48.98 / $190.55	Professional		$30.90	$48.98	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $61.66	Professional	26	$7.94	$12.88	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $29.51 / $60.26	Professional	TC	$21.88	$29.51	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $52.48 / $79.43	Professional		$31.62	$52.48	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $23.44	Professional	26	$9.12	$14.45	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $37.15 / $56.23	Professional	TC	$22.39	$37.15	$56.23
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $60.26 / $63.10	Professional		$18.62	$60.26	$63.10
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $15.14 / $16.22	Professional	26	$14.45	$15.14	$16.22
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $45.71 / $47.86	Professional	TC	$43.65	$45.71	$47.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $56.23 / $64.57	Professional		$51.29	$56.23	$64.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $13.18 / $15.49	Professional	26	$12.02	$13.18	$15.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $42.66 / $50.12	Professional	TC	$38.90	$42.66	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $81.28	Professional		$47.86	$57.54	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.22 / $21.88	Professional	26	$12.59	$16.22	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $40.74 / $57.54	Professional	TC	$35.48	$40.74	$57.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $97.72	Professional		$54.95	$67.61	$97.72
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.98 / $27.54	Professional	26	$13.18	$16.98	$27.54
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $51.29 / $69.18	Professional	TC	$41.69	$51.29	$69.18