Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.96 / $34.72 / $49.50	Professional		$25.96	$34.72	$49.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.44 / $48.96 / $107.10	Professional	26	$19.44	$48.96	$107.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.51 / $6.51 / $16.38	Professional	TC	$6.51	$6.51	$16.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.58 / $38.58 / $38.58	Professional		$38.58	$38.58	$38.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.50 / $26.50 / $26.50	Professional	26	$26.50	$26.50	$26.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.08 / $12.08 / $12.08	Professional	TC	$12.08	$12.08	$12.08
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.03 / $43.20 / $62.19	Professional		$9.03	$43.20	$62.19
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $31.11 / $32.58 / $45.01	Professional	26	$31.11	$32.58	$45.01
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $10.15 / $10.63 / $16.48	Professional	TC	$10.15	$10.63	$16.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $37.03 / $43.20	Professional		$33.95	$37.03	$43.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $25.44 / $29.68	Professional	26	$23.32	$25.44	$29.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $10.63 / $11.59 / $13.52	Professional	TC	$10.63	$11.59	$13.52
United Facility/Professional Professional Modifier Low / Median / High Price $38.58 / $38.58 / $48.62	Professional		$38.58	$38.58	$48.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.50 / $26.50 / $36.22	Professional	26	$26.50	$26.50	$36.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.08 / $12.08 / $12.39	Professional	TC	$12.08	$12.08	$12.39
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $40.47 / $58.64	Professional		$27.61	$40.47	$58.64
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $20.36 / $29.21 / $42.75	Professional	26	$20.36	$29.21	$42.75
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $7.25 / $10.39 / $15.89	Professional	TC	$7.25	$10.39	$15.89