Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.99 / $41.95 / $236.41	Facility		$34.99	$41.95	$236.41
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.68 / $8.71 / $10.25	Facility	26	$7.68	$8.71	$10.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.28 / $37.97 / $236.41	Facility	TC	$27.28	$37.97	$236.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.13 / $37.97 / $98.20	Professional		$11.13	$37.97	$98.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $10.65 / $11.72	Professional	26	$7.03	$10.65	$11.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.98 / $10.98 / $10.98	Professional	52	$10.98	$10.98	$10.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $23.10 / $45.59	Professional	TC	$18.53	$23.10	$45.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.15 / $36.15 / $36.15	Facility		$36.15	$36.15	$36.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.29 / $32.40 / $46.62	Professional		$28.29	$32.40	$46.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.22 / $11.39	Professional	26	$8.71	$9.22	$11.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $22.91 / $36.36	Professional	TC	$19.43	$22.91	$36.36
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.42 / $35.69 / $48.21	Professional		$9.42	$35.69	$48.21
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 $35.03 / $36.68 / $37.13	Professional	TC	$35.03	$36.68	$37.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $41.44 / $48.34	Professional		$37.97	$41.44	$48.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.35 / $9.11 / $10.63	Professional	26	$8.35	$9.11	$10.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.63 / $32.33 / $34.21	Professional	TC	$29.63	$32.33	$34.21
United Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $46.62 / $53.39	Professional		$17.30	$46.62	$53.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.88 / $10.25 / $13.40	Professional	26	$4.88	$10.25	$13.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.42 / $36.36 / $39.99	Professional	TC	$12.42	$36.36	$39.99
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $31.12 / $50.67 / $76.91	Professional		$31.12	$50.67	$76.91
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.89 / $20.39	Professional	26	$7.94	$11.89	$20.39
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $36.15 / $56.49	Professional	TC	$23.17	$36.15	$56.49