Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.01 / $38.01 / $93.85	Professional		$38.01	$38.01	$93.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $34.67 / $47.00	Professional	26	$26.53	$34.67	$47.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $11.48 / $46.85	Professional	TC	$11.48	$11.48	$46.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.16 / $72.16 / $72.16	Professional		$72.16	$72.16	$72.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $37.54 / $37.54	Professional	26	$37.54	$37.54	$37.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.60 / $34.60 / $34.60	Professional	TC	$34.60	$34.60	$34.60
HMSA Facility/Professional Professional Modifier Low / Median / High Price $24.35 / $73.19 / $92.72	Professional		$24.35	$73.19	$92.72
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $42.28 / $44.27 / $62.72	Professional	26	$42.28	$44.27	$62.72
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $28.65 / $30.01	Professional	TC	$27.01	$28.65	$30.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.50 / $69.28 / $80.81	Professional		$63.50	$69.28	$80.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $36.04 / $42.06	Professional	26	$33.04	$36.04	$42.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.45 / $33.22 / $38.75	Professional	TC	$30.45	$33.22	$38.75
United Facility/Professional Professional Modifier Low / Median / High Price $72.16 / $72.16 / $90.42	Professional		$72.16	$72.16	$90.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $95.00 / $152.38	Professional	26	$37.54	$95.00	$152.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.60 / $34.60 / $39.36	Professional	TC	$34.60	$34.60	$39.36
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.44 / $68.11 / $102.95	Professional		$46.44	$68.11	$102.95
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $28.77 / $42.99 / $59.97	Professional	26	$28.77	$42.99	$59.97
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $11.64 / $19.92 / $42.98	Professional	TC	$11.64	$19.92	$42.98