Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.94 / $54.58 / $347.26	Facility		$40.94	$54.58	$347.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.38 / $9.50 / $11.18	Facility	26	$8.38	$9.50	$11.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.88 / $297.00 / $376.80	Facility	TC	$36.88	$297.00	$376.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.21 / $43.13 / $111.50	Professional		$11.21	$43.13	$111.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $11.89 / $31.54	Professional	26	$8.27	$11.89	$31.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.23 / $41.60 / $111.78	Professional	50	$29.23	$41.60	$111.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $44.18 / $89.90	Professional	TC	$21.64	$44.18	$89.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.75 / $41.75 / $41.75	Facility		$41.75	$41.75	$41.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.44 / $32.44 / $32.44	Facility	TC	$32.44	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.64 / $36.65 / $54.58	Professional		$30.64	$36.65	$54.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $9.80 / $12.17	Professional	26	$9.50	$9.80	$12.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.97 / $26.85 / $43.39	Professional	TC	$20.97	$26.85	$43.39
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.81 / $38.50 / $58.71	Professional		$9.81	$38.50	$58.71
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $11.26 / $11.54	Professional	26	$10.75	$11.26	$11.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $40.33 / $45.05 / $47.17	Professional	TC	$40.33	$45.05	$47.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.47 / $48.52 / $56.60	Professional		$44.47	$48.52	$56.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $9.94 / $11.59	Professional	26	$9.11	$9.94	$11.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.35 / $38.57 / $40.82	Professional	TC	$35.35	$38.57	$40.82
United Facility/Professional Professional Modifier Low / Median / High Price $19.03 / $54.58 / $58.88	Professional		$19.03	$54.58	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.09 / $11.18 / $13.94	Professional	26	$5.09	$11.18	$13.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.93 / $43.39 / $44.94	Professional	TC	$13.93	$43.39	$44.94
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.78 / $54.24 / $82.48	Professional		$34.78	$54.24	$82.48
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.48 / $21.23	Professional	26	$8.27	$12.48	$21.23
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.51 / $42.66 / $61.23	Professional	TC	$26.51	$42.66	$61.23