Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.41 / $86.35 / $472.60	Professional		$66.41	$86.35	$472.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.33 / $83.88 / $452.20	Professional	26	$36.33	$83.88	$452.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.96 / $40.72 / $96.04	Professional	TC	$25.96	$40.72	$96.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.89 / $94.89 / $94.89	Professional		$94.89	$94.89	$94.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.41 / $45.41 / $45.41	Professional	26	$45.41	$45.41	$45.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.48 / $49.48 / $49.48	Professional	TC	$49.48	$49.48	$49.48
HMSA Facility/Professional Professional Modifier Low / Median / High Price $48.95 / $137.57 / $207.53	Professional		$48.95	$137.57	$207.53
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $57.59 / $81.03	Professional	26	$55.00	$57.59	$81.03
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $76.37 / $79.97 / $126.51	Professional	TC	$76.37	$79.97	$126.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.50 / $91.09 / $106.27	Professional		$83.50	$91.09	$106.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.96 / $43.60 / $50.86	Professional	26	$39.96	$43.60	$50.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.54 / $47.50 / $55.41	Professional	TC	$43.54	$47.50	$55.41
United Facility/Professional Professional Modifier Low / Median / High Price $94.89 / $94.89 / $116.48	Professional		$94.89	$94.89	$116.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.41 / $45.41 / $61.64	Professional	26	$45.41	$45.41	$61.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.79 / $49.48 / $75.00	Professional	TC	$39.79	$49.48	$75.00
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $87.92 / $113.15 / $199.11	Professional		$87.92	$113.15	$199.11
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $35.39 / $53.41 / $72.63	Professional	26	$35.39	$53.41	$72.63
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $33.47 / $63.09 / $131.53	Professional	TC	$33.47	$63.09	$131.53