Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $109.65	Professional		$50.12	$60.26	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.91 / $19.50	Professional	26	$7.08	$8.91	$19.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	52	$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $48.98 / $70.79	Professional	TC	$41.69	$48.98	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $72.44 / $169.82	Professional		$58.88	$72.44	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.72 / $23.44	Professional	26	$8.91	$10.72	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $61.66 / $144.54	Professional	TC	$50.12	$61.66	$144.54
HMSA Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $72.44 / $89.13	Professional		$12.30	$72.44	$89.13
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.47 / $10.72	Professional	26	$10.00	$10.47	$10.72
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $64.57 / $64.57	Professional	TC	$61.66	$64.57	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $107.15	Professional		$70.79	$85.11	$107.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $11.48 / $14.45	Professional	26	$9.55	$11.48	$14.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $74.13 / $91.20	Professional	TC	$61.66	$74.13	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $102.33	Professional		$50.12	$70.79	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.72 / $15.14	Professional	26	$7.76	$10.72	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $60.26 / $87.10	Professional	TC	$41.69	$60.26	$87.10
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $245.47	Professional		$57.54	$77.62	$245.47
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $17.38	Professional	26	$7.94	$10.47	$17.38
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $66.07 / $107.15	Professional	TC	$48.98	$66.07	$107.15