Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $89.13 / $147.91	Professional		$60.26	$89.13	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $27.54 / $85.11	Professional	26	$19.95	$27.54	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $41.69 / $72.44	Professional	TC	$31.62	$41.69	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $32.36 / $95.50	Professional		$29.51	$32.36	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $13.18 / $27.54	Professional	26	$11.48	$13.18	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $18.20 / $67.61	Professional	TC	$17.38	$18.20	$67.61
HMSA Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $97.72 / $138.04	Professional		$35.48	$97.72	$138.04
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $60.26	Professional	26	$39.81	$41.69	$60.26
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $56.23 / $77.62	Professional	TC	$53.70	$56.23	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $91.20 / $104.71	Professional		$83.18	$91.20	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $26.30 / $30.20	Professional	26	$23.99	$26.30	$30.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $64.57 / $75.86	Professional	TC	$58.88	$64.57	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $38.90 / $104.71	Professional		$33.88	$38.90	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $18.20 / $36.31	Professional	26	$13.49	$18.20	$36.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $20.42 / $67.61	Professional	TC	$20.42	$20.42	$67.61
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $97.72 / $141.25	Professional		$58.88	$97.72	$141.25
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $50.12	Professional	26	$23.99	$35.48	$50.12
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $67.61 / $89.13	Professional	TC	$25.12	$67.61	$89.13