Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $66.42 / $95.54	Professional		$48.60	$66.42	$95.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.77 / $68.00 / $120.39	Professional	26	$34.77	$68.00	$120.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.43 / $21.43 / $41.18	Professional	TC	$21.43	$21.43	$41.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.88 / $73.88 / $73.88	Professional		$73.88	$73.88	$73.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.46 / $43.46 / $43.46	Professional	26	$43.46	$43.46	$43.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.43 / $30.43 / $30.43	Professional	TC	$30.43	$30.43	$30.43
HMSA Facility/Professional Professional Modifier Low / Median / High Price $20.09 / $68.40 / $102.40	Professional		$20.09	$68.40	$102.40
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $42.74 / $44.75 / $64.31	Professional	26	$42.74	$44.75	$64.31
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $23.63 / $38.08	Professional	TC	$22.57	$23.63	$38.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.01 / $70.92 / $82.74	Professional		$65.01	$70.92	$82.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.25 / $41.72 / $48.68	Professional	26	$38.25	$41.72	$48.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.77 / $29.21 / $34.08	Professional	TC	$26.77	$29.21	$34.08
United Facility/Professional Professional Modifier Low / Median / High Price $73.88 / $73.88 / $92.16	Professional		$73.88	$73.88	$92.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.46 / $43.46 / $58.98	Professional	26	$43.46	$43.46	$58.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.43 / $33.18 / $33.18	Professional	TC	$30.43	$33.18	$33.18
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $53.66 / $79.52 / $111.09	Professional		$53.66	$79.52	$111.09
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.09 / $46.82 / $69.56	Professional	26	$33.09	$46.82	$69.56
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $32.86 / $45.08	Professional	TC	$18.68	$32.86	$45.08