Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $109.65 / $234.42	Facility		$81.28	$109.65	$234.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $36.31 / $43.65	Facility	26	$32.36	$36.31	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $97.72 / $354.81	Professional		$53.70	$97.72	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $51.29 / $154.88	Professional	26	$28.84	$51.29	$154.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $223.87 / $645.65	Professional	50	$79.43	$223.87	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $58.88 / $147.91	Professional	TC	$43.65	$58.88	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $107.15 / $213.80	Professional		$60.26	$107.15	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $39.81 / $72.44	Professional	26	$23.99	$39.81	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $67.61 / $141.25	Professional	TC	$36.31	$67.61	$141.25
HMSA Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $107.15 / $134.90	Professional		$67.61	$107.15	$134.90
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $43.65 / $44.67	Professional	26	$41.69	$43.65	$44.67
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $79.43 / $87.10	Professional	TC	$75.86	$79.43	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $109.65 / $128.82	Professional		$100.00	$109.65	$128.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $38.02 / $44.67	Professional	26	$35.48	$38.02	$44.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $70.79 / $83.18	Professional	TC	$64.57	$70.79	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $173.78	Professional		$89.13	$123.03	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $43.65 / $66.07	Professional	26	$32.36	$43.65	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $109.65	Professional	TC	$54.95	$75.86	$109.65
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $229.09	Professional		$112.20	$141.25	$229.09
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $50.12 / $81.28	Professional	26	$39.81	$50.12	$81.28
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $91.20 / $144.54	Professional	TC	$72.44	$91.20	$144.54