Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.59 / $90.59 / $153.16	Professional		$90.59	$90.59	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.02 / $75.45 / $192.02	Professional	26	$71.02	$75.45	$192.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.35 / $36.35 / $58.83	Professional	TC	$36.35	$36.35	$58.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.89 / $118.89 / $118.89	Professional		$118.89	$118.89	$118.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $75.45 / $75.45	Professional	26	$75.45	$75.45	$75.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.44 / $43.44 / $43.44	Professional	TC	$43.44	$43.44	$43.44
HMSA Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $128.10 / $154.68	Professional		$34.29	$128.10	$154.68
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $83.64 / $87.58 / $120.08	Professional	26	$83.64	$87.58	$120.08
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $38.52 / $40.34 / $44.84	Professional	TC	$38.52	$40.34	$44.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.62 / $114.13 / $133.15	Professional		$104.62	$114.13	$133.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.40 / $72.43 / $84.50	Professional	26	$66.40	$72.43	$84.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.22 / $41.70 / $48.65	Professional	TC	$38.22	$41.70	$48.65
United Facility/Professional Professional Modifier Low / Median / High Price $118.89 / $118.89 / $148.15	Professional		$118.89	$118.89	$148.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $75.45 / $102.59	Professional	26	$75.45	$75.45	$102.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.44 / $43.44 / $45.56	Professional	TC	$43.44	$43.44	$45.56
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $99.20 / $132.80 / $174.99	Professional		$99.20	$132.80	$174.99
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $58.63 / $88.51 / $121.59	Professional	26	$58.63	$88.51	$121.59
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $30.01 / $46.91 / $62.12	Professional	TC	$30.01	$46.91	$62.12