Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $51.29 / $323.59	Facility		$45.71	$51.29	$323.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $9.55 / $11.22	Facility	26	$8.32	$9.55	$11.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.15 / $48.98 / $407.38	Facility	TC	$37.15	$48.98	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $46.77 / $190.55	Professional		$11.48	$46.77	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.02 / $51.29	Professional	26	$7.59	$12.02	$51.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $44.67 / $44.67	Professional	50	$17.78	$44.67	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $34.67 / $79.43	Professional	TC	$20.89	$34.67	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $40.74 / $74.13	Professional		$29.51	$40.74	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $18.62	Professional	26	$6.92	$10.47	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $56.23	Professional	TC	$20.89	$30.20	$56.23
HMSA Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $67.61	Professional		$52.48	$63.10	$67.61
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $10.96 / $11.48	Professional	26	$10.72	$10.96	$11.48
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $48.98 / $56.23	Professional	TC	$46.77	$48.98	$56.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $57.54 / $66.07	Professional		$52.48	$57.54	$66.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.72 / $12.59	Professional	26	$9.77	$10.72	$12.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $46.77 / $53.70	Professional	TC	$42.66	$46.77	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $51.29 / $79.43	Professional		$42.66	$51.29	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.22 / $16.98	Professional	26	$9.77	$11.22	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $39.81 / $60.26	Professional	TC	$31.62	$39.81	$60.26
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $79.43	Professional		$40.74	$63.10	$79.43
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.59 / $18.62	Professional	26	$9.33	$12.59	$18.62
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $50.12 / $61.66	Professional	TC	$30.90	$50.12	$61.66