Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.42 / $84.42 / $191.19	Professional		$84.42	$84.42	$191.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.05 / $203.15 / $203.15	Professional	26	$75.05	$203.15	$203.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.30 / $56.30 / $61.21	Professional	TC	$56.30	$56.30	$61.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.94 / $149.94 / $149.94	Professional		$149.94	$149.94	$149.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.36 / $108.36 / $108.36	Professional	26	$108.36	$108.36	$108.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.58 / $41.58 / $41.58	Professional	TC	$41.58	$41.58	$41.58
HMSA Facility/Professional Professional Modifier Low / Median / High Price $46.15 / $155.40 / $239.94	Professional		$46.15	$155.40	$239.94
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $96.56 / $101.11 / $143.68	Professional	26	$96.56	$101.11	$143.68
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $51.85 / $54.29 / $96.25	Professional	TC	$51.85	$54.29	$96.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.94 / $143.94 / $167.93	Professional		$131.94	$143.94	$167.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $95.36 / $104.03 / $121.37	Professional	26	$95.36	$104.03	$121.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.59 / $39.90 / $46.56	Professional	TC	$36.59	$39.90	$46.56
United Facility/Professional Professional Modifier Low / Median / High Price $149.94 / $149.94 / $187.42	Professional		$149.94	$149.94	$187.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.36 / $108.36 / $141.86	Professional	26	$108.36	$108.36	$141.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.58 / $41.58 / $45.56	Professional	TC	$41.58	$41.58	$45.56
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $103.38 / $164.35 / $269.87	Professional		$103.38	$164.35	$269.87
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $78.83 / $113.24 / $165.66	Professional	26	$78.83	$113.24	$165.66
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $63.40 / $116.35	Professional	TC	$26.43	$63.40	$116.35