Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $63.48 / $127.50	Professional		$36.26	$63.48	$127.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $13.76 / $52.70	Professional	26	$8.55	$13.76	$52.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.49 / $21.56 / $53.75	Professional	TC	$21.49	$21.56	$53.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $57.66 / $57.66	Professional		$57.66	$57.66	$57.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.76 / $13.76 / $13.76	Professional	26	$13.76	$13.76	$13.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.90 / $43.90 / $43.90	Professional	TC	$43.90	$43.90	$43.90
HMSA Facility/Professional Professional Modifier Low / Median / High Price $14.53 / $73.93 / $121.14	Professional		$14.53	$73.93	$121.14
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $17.09 / $23.31	Professional	26	$16.32	$17.09	$23.31
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $54.28 / $56.84 / $97.84	Professional	TC	$54.28	$56.84	$97.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.74 / $55.36 / $64.58	Professional		$50.74	$55.36	$64.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.11 / $13.21 / $15.41	Professional	26	$12.11	$13.21	$15.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.63 / $42.14 / $49.17	Professional	TC	$38.63	$42.14	$49.17
United Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $57.66 / $69.67	Professional		$57.66	$57.66	$69.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.76 / $13.76 / $18.53	Professional	26	$13.76	$13.76	$18.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.90 / $43.90 / $51.14	Professional	TC	$43.90	$43.90	$51.14
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.56 / $68.69 / $122.89	Professional		$46.56	$68.69	$122.89
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $16.16 / $25.40	Professional	26	$10.61	$16.16	$25.40
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $29.78 / $52.82 / $101.01	Professional	TC	$29.78	$52.82	$101.01