Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.44 / $109.40 / $397.29	Professional		$87.44	$109.40	$397.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.16 / $140.32 / $373.02	Professional	26	$70.16	$140.32	$373.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $33.15 / $76.47	Professional	TC	$33.15	$33.15	$76.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.43 / $132.43 / $132.43	Professional		$132.43	$132.43	$132.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.98 / $75.98 / $75.98	Professional	26	$75.98	$75.98	$75.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.44 / $56.44 / $56.44	Professional	TC	$56.44	$56.44	$56.44
HMSA Facility/Professional Professional Modifier Low / Median / High Price $41.34 / $139.88 / $175.66	Professional		$41.34	$139.88	$175.66
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $85.08 / $89.09 / $127.05	Professional	26	$85.08	$89.09	$127.05
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $46.44 / $48.63 / $50.36	Professional	TC	$46.44	$48.63	$50.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $116.53 / $127.13 / $148.32	Professional		$116.53	$127.13	$148.32
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.86 / $72.94 / $85.09	Professional	26	$66.86	$72.94	$85.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $49.67 / $54.18 / $63.21	Professional	TC	$49.67	$54.18	$63.21
United Facility/Professional Professional Modifier Low / Median / High Price $132.43 / $132.43 / $162.47	Professional		$132.43	$132.43	$162.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.98 / $75.98 / $102.66	Professional	26	$75.98	$75.98	$102.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $56.44 / $59.81	Professional	TC	$17.28	$56.44	$59.81
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $95.46 / $140.38 / $187.78	Professional		$95.46	$140.38	$187.78
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $58.01 / $85.78 / $121.70	Professional	26	$58.01	$85.78	$121.70
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $21.70 / $52.98 / $68.30	Professional	TC	$21.70	$52.98	$68.30