Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.52 / $53.07 / $313.73	Facility		$38.52	$53.07	$313.73
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 $35.61 / $187.83 / $344.80	Facility	TC	$35.61	$187.83	$344.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.89 / $47.39 / $111.50	Professional		$11.89	$47.39	$111.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.10 / $40.82	Professional	26	$8.13	$12.10	$40.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.99 / $112.99 / $112.99	Professional	50	$112.99	$112.99	$112.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.34 / $12.34 / $12.34	Professional	52	$12.34	$12.34	$12.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $44.18 / $52.52	Professional	TC	$21.94	$44.18	$52.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $41.01 / $41.01	Facility		$41.01	$41.01	$41.01
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 $31.68 / $31.68 / $31.68	Facility	TC	$31.68	$31.68	$31.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.64 / $37.13 / $53.92	Professional		$30.64	$37.13	$53.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $9.92 / $12.17	Professional	26	$9.50	$9.92	$12.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.97 / $27.03 / $41.89	Professional	TC	$20.97	$27.03	$41.89
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.81 / $38.50 / $60.69	Professional		$9.81	$38.50	$60.69
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 $40.82 / $46.94 / $49.15	Professional	TC	$40.82	$46.94	$49.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.24 / $47.17 / $55.03	Professional		$43.24	$47.17	$55.03
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 $34.13 / $37.24 / $39.40	Professional	TC	$34.13	$37.24	$39.40
United Facility/Professional Professional Modifier Low / Median / High Price $19.03 / $53.07 / $58.88	Professional		$19.03	$53.07	$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 / $33.96 / $44.94	Professional	TC	$13.93	$33.96	$44.94
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $57.17 / $81.54	Professional		$35.88	$57.17	$81.54
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 $27.61 / $43.09 / $60.28	Professional	TC	$27.61	$43.09	$60.28