Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.77 / $196.89 / $301.02	Professional		$133.77	$196.89	$301.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.00 / $157.82 / $416.50	Professional	26	$68.00	$157.82	$416.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.23 / $72.23 / $194.98	Professional	TC	$72.23	$72.23	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.99 / $228.99 / $228.99	Professional		$228.99	$228.99	$228.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $85.00 / $85.00	Professional	26	$85.00	$85.00	$85.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.00 / $144.00 / $144.00	Professional	TC	$144.00	$144.00	$144.00
HMSA Facility/Professional Professional Modifier Low / Median / High Price $86.68 / $205.62 / $271.25	Professional		$86.68	$205.62	$271.25
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $98.91 / $103.57 / $148.21	Professional	26	$98.91	$103.57	$148.21
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $97.39 / $101.98 / $123.04	Professional	TC	$97.39	$101.98	$123.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $201.51 / $219.83 / $256.47	Professional		$201.51	$219.83	$256.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.80 / $81.59 / $95.20	Professional	26	$74.80	$81.59	$95.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $126.72 / $138.24 / $161.28	Professional	TC	$126.72	$138.24	$161.28
United Facility/Professional Professional Modifier Low / Median / High Price $228.99 / $258.27 / $258.27	Professional		$228.99	$258.27	$258.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $115.76 / $115.76	Professional	26	$85.00	$115.76	$115.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.52 / $142.52 / $144.00	Professional	TC	$142.52	$142.52	$144.00
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $122.26 / $218.31 / $302.58	Professional		$122.26	$218.31	$302.58
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $97.65 / $136.47	Professional	26	$66.20	$97.65	$136.47
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $36.72 / $115.10 / $169.34	Professional	TC	$36.72	$115.10	$169.34