Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.79 / $81.41 / $149.60	Professional		$74.79	$81.41	$149.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.22 / $27.31 / $84.15	Professional	26	$25.22	$27.31	$84.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.20 / $50.20 / $90.98	Professional	TC	$50.20	$50.20	$90.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.44 / $94.44 / $94.44	Professional		$94.44	$94.44	$94.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.31 / $27.31 / $27.31	Professional	26	$27.31	$27.31	$27.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.13 / $67.13 / $67.13	Professional	TC	$67.13	$67.13	$67.13
HMSA Facility/Professional Professional Modifier Low / Median / High Price $35.49 / $90.92 / $137.26	Professional		$35.49	$90.92	$137.26
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $39.86 / $41.75 / $59.84	Professional	26	$39.86	$41.75	$59.84
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $46.90 / $49.11 / $77.41	Professional	TC	$46.90	$49.11	$77.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.11 / $90.66 / $105.77	Professional		$83.11	$90.66	$105.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.04 / $26.22 / $30.59	Professional	26	$24.04	$26.22	$30.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $59.07 / $64.44 / $75.18	Professional	TC	$59.07	$64.44	$75.18
United Facility/Professional Professional Modifier Low / Median / High Price $94.44 / $104.55 / $104.55	Professional		$94.44	$104.55	$104.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.31 / $27.31 / $36.69	Professional	26	$27.31	$27.31	$36.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.13 / $67.13 / $67.86	Professional	TC	$67.13	$67.13	$67.86
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $95.95 / $143.97	Professional		$57.06	$95.95	$143.97
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $21.00 / $36.39 / $51.62	Professional	26	$21.00	$36.39	$51.62
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $23.49 / $61.76 / $92.35	Professional	TC	$23.49	$61.76	$92.35