Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.31 / $82.74 / $315.45	Facility		$37.31	$82.74	$315.45
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.01 / $9.08 / $10.68	Facility	26	$8.01	$9.08	$10.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.04 / $187.83 / $340.00	Facility	TC	$33.04	$187.83	$340.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $52.72 / $105.44	Professional		$28.64	$52.72	$105.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.77 / $11.37 / $38.93	Professional	26	$7.77	$11.37	$38.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $27.96 / $27.96 / $307.37	Professional	50	$27.96	$27.96	$307.37
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 $21.32 / $38.88 / $92.40	Professional	TC	$21.32	$38.88	$92.40
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 $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
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 $22.18 / $32.75 / $50.65	Professional		$22.18	$32.75	$50.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $9.80 / $11.63	Professional	26	$9.08	$9.80	$11.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.97 / $26.58 / $39.02	Professional	TC	$20.97	$26.58	$39.02
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.81 / $38.50 / $53.98	Professional		$9.81	$38.50	$53.98
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 $37.93 / $40.53 / $42.44	Professional	TC	$37.93	$40.53	$42.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.38 / $44.05 / $51.39	Professional		$40.38	$44.05	$51.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $9.49 / $11.07	Professional	26	$8.69	$9.49	$11.07
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 $17.89 / $49.56 / $55.17	Professional		$17.89	$49.56	$55.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.91 / $10.68 / $13.32	Professional	26	$4.91	$10.68	$13.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.98 / $38.88 / $41.85	Professional	TC	$12.98	$38.88	$41.85
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.69 / $53.93 / $75.83	Professional		$33.69	$53.93	$75.83
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $12.32 / $20.29	Professional	26	$7.90	$12.32	$20.29
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $42.34 / $55.55	Professional	TC	$26.13	$42.34	$55.55