Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $50.12 / $346.74	Facility		$43.65	$50.12	$346.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $10.23 / $12.02	Facility	26	$9.12	$10.23	$12.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $44.67 / $363.08	Facility	TC	$35.48	$44.67	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $51.29 / $208.93	Professional		$11.75	$51.29	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.85 / $56.23	Professional	26	$7.94	$15.85	$56.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $13.49 / $89.13 / $251.19	Professional	50	$13.49	$89.13	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $35.48 / $97.72	Professional	TC	$20.89	$35.48	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $75.86	Professional		$30.20	$40.74	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.96 / $19.95	Professional	26	$8.13	$10.96	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $29.51 / $56.23	Professional	TC	$21.88	$29.51	$56.23
HMSA Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $67.61	Professional		$46.77	$60.26	$67.61
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.02 / $12.59	Professional	26	$11.75	$12.02	$12.59
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $47.86 / $54.95	Professional	TC	$45.71	$47.86	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $56.23 / $66.07	Professional		$51.29	$56.23	$66.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $11.48 / $13.49	Professional	26	$10.47	$11.48	$13.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $44.67 / $52.48	Professional	TC	$40.74	$44.67	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $79.43	Professional		$43.65	$52.48	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.02 / $18.62	Professional	26	$10.47	$12.02	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.02 / $60.26	Professional	TC	$32.36	$38.02	$60.26
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $64.57 / $81.28	Professional		$39.81	$64.57	$81.28
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.80 / $19.95	Professional	26	$10.23	$13.80	$19.95
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $48.98 / $60.26	Professional	TC	$31.62	$48.98	$60.26