Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.14 / $64.14 / $141.77	Professional		$64.14	$64.14	$141.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.94 / $84.15 / $84.15	Professional	26	$24.94	$84.15	$84.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.20 / $39.20 / $99.38	Professional	TC	$39.20	$39.20	$99.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.41 / $107.41 / $107.41	Professional		$107.41	$107.41	$107.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.03 / $34.03 / $34.03	Professional	26	$34.03	$34.03	$34.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.39 / $73.39 / $73.39	Professional	TC	$73.39	$73.39	$73.39
HMSA Facility/Professional Professional Modifier Low / Median / High Price $85.41 / $119.66 / $125.30	Professional		$85.41	$119.66	$125.30
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $39.86 / $57.15 / $59.84	Professional	26	$39.86	$57.15	$59.84
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.30 / $62.51 / $65.45	Professional	TC	$45.30	$62.51	$65.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.52 / $103.12 / $120.30	Professional		$94.52	$103.12	$120.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.94 / $32.65 / $38.11	Professional	26	$29.94	$32.65	$38.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $64.58 / $70.45 / $82.19	Professional	TC	$64.58	$70.45	$82.19
United Facility/Professional Professional Modifier Low / Median / High Price $107.41 / $107.41 / $114.80	Professional		$107.41	$107.41	$114.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.03 / $143.83 / $143.83	Professional	26	$34.03	$143.83	$143.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.09 / $69.09 / $73.39	Professional	TC	$69.09	$69.09	$73.39
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $93.78 / $142.94	Professional		$56.28	$93.78	$142.94
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $26.70 / $39.46 / $54.48	Professional	26	$26.70	$39.46	$54.48
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $54.88 / $88.46	Professional	TC	$23.57	$54.88	$88.46