Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.22 / $70.73 / $347.26	Facility		$37.22	$70.73	$347.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.06 / $9.13 / $10.75	Facility	26	$8.06	$9.13	$10.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.16 / $38.88 / $287.08	Facility	TC	$29.16	$38.88	$287.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.75 / $36.93 / $103.40	Professional		$10.75	$36.93	$103.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $11.62 / $38.03	Professional	26	$7.96	$11.62	$38.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $104.52 / $104.52 / $104.52	Professional	50	$104.52	$104.52	$104.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.55 / $11.55 / $11.55	Professional	52	$11.55	$11.55	$11.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $23.82 / $48.73	Professional	TC	$19.46	$23.82	$48.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $38.40 / $38.40	Facility		$38.40	$38.40	$38.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $34.22 / $49.68	Professional		$30.25	$34.22	$49.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.13 / $10.19 / $11.94	Professional	26	$9.13	$10.19	$11.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $23.83 / $38.88	Professional	TC	$20.59	$23.83	$38.88
HMSA Facility/Professional Professional Modifier Low / Median / High Price $10.17 / $37.81 / $51.36	Professional		$10.17	$37.81	$51.36
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $11.66 / $11.96	Professional	26	$11.14	$11.66	$11.96
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $37.44 / $39.20 / $39.40	Professional	TC	$37.44	$39.20	$39.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $44.11 / $51.46	Professional		$40.44	$44.11	$51.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.76 / $9.55 / $11.14	Professional	26	$8.76	$9.55	$11.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.68 / $34.56 / $36.58	Professional	TC	$31.68	$34.56	$36.58
United Facility/Professional Professional Modifier Low / Median / High Price $18.25 / $49.63 / $56.48	Professional		$18.25	$49.63	$56.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.88 / $13.40 / $86.60	Professional	26	$4.88	$13.40	$86.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.37 / $38.88 / $43.08	Professional	TC	$13.37	$38.88	$43.08
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $53.52 / $80.70	Professional		$33.40	$53.52	$80.70
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $12.46 / $20.39	Professional	26	$9.09	$12.46	$20.39
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $24.28 / $38.99 / $60.28	Professional	TC	$24.28	$38.99	$60.28