Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.60 / $213.10 / $347.26	Facility		$32.60	$213.10	$347.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.72 / $9.88 / $11.62	Facility	26	$8.72	$9.88	$11.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.90 / $30.78 / $32.82	Facility	TC	$23.90	$30.78	$32.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $43.47 / $67.31	Professional		$24.69	$43.47	$67.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $9.33 / $32.92	Professional	26	$8.61	$9.33	$32.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.04 / $39.92	Professional	TC	$16.60	$20.04	$39.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $33.92 / $33.92	Facility		$33.92	$33.92	$33.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.02 / $36.34 / $43.47	Professional		$30.02	$36.34	$43.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $10.47 / $12.65	Professional	26	$9.88	$10.47	$12.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $24.16 / $31.86	Professional	TC	$19.55	$24.16	$31.86
HMSA Facility/Professional Professional Modifier Low / Median / High Price $10.24 / $37.81 / $44.18	Professional		$10.24	$37.81	$44.18
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $11.76 / $12.05	Professional	26	$11.23	$11.76	$12.05
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $30.68 / $32.13 / $32.13	Professional	TC	$30.68	$32.13	$32.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.42 / $38.64 / $45.08	Professional		$35.42	$38.64	$45.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $10.33 / $12.05	Professional	26	$9.47	$10.33	$12.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.96 / $28.32 / $29.97	Professional	TC	$25.96	$28.32	$29.97
United Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $43.47 / $48.90	Professional		$16.00	$43.47	$48.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.30 / $14.49 / $87.90	Professional	26	$5.30	$14.49	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.70 / $26.58 / $34.40	Professional	TC	$10.70	$26.58	$34.40
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $39.57 / $48.44 / $70.01	Professional		$39.57	$48.44	$70.01
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $13.66 / $22.08	Professional	26	$10.64	$13.66	$22.08
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $27.11 / $35.38 / $47.96	Professional	TC	$27.11	$35.38	$47.96