Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.61 / $204.17	Professional		$50.12	$67.61	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $53.70 / $120.23	Professional	26	$34.67	$53.70	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $21.88 / $33.11	Professional	TC	$14.45	$21.88	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $27.54 / $74.13	Professional		$24.55	$27.54	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $18.20 / $43.65	Professional	26	$16.22	$18.20	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.51 / $9.33 / $30.20	Professional	TC	$8.51	$9.33	$30.20
HMSA Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $70.79 / $102.33	Professional		$21.88	$70.79	$102.33
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $44.67 / $64.57	Professional	26	$42.66	$44.67	$64.57
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $25.70 / $38.02	Professional	TC	$24.55	$25.70	$38.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $70.79 / $81.28	Professional		$64.57	$70.79	$81.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $41.69 / $47.86	Professional	26	$38.02	$41.69	$47.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $28.84 / $33.88	Professional	TC	$26.30	$28.84	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $31.62 / $91.20	Professional		$29.51	$31.62	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $21.38 / $58.88	Professional	26	$19.50	$21.38	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $10.00 / $33.11	Professional	TC	$10.00	$10.00	$33.11
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $79.43 / $100.00	Professional		$53.70	$79.43	$100.00
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $47.86 / $57.54	Professional	26	$36.31	$47.86	$57.54
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.88 / $43.65	Professional	TC	$19.05	$33.88	$43.65