Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.83 / $55.83 / $94.11	Professional		$55.83	$55.83	$94.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.12 / $46.00 / $234.28	Professional	26	$43.12	$46.00	$234.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $22.85 / $36.54	Professional	TC	$22.85	$22.85	$36.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.95 / $72.95 / $72.95	Professional		$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.00 / $46.00 / $46.00	Professional	26	$46.00	$46.00	$46.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.95 / $26.95 / $26.95	Professional	TC	$26.95	$26.95	$26.95
HMSA Facility/Professional Professional Modifier Low / Median / High Price $19.52 / $66.09 / $80.51	Professional		$19.52	$66.09	$80.51
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $41.10 / $52.76 / $58.62	Professional	26	$41.10	$52.76	$58.62
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $22.97 / $25.54	Professional	TC	$21.94	$22.97	$25.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $70.03 / $81.70	Professional		$64.20	$70.03	$81.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $44.16 / $51.52	Professional	26	$40.47	$44.16	$51.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $25.87 / $30.18	Professional	TC	$23.72	$25.87	$30.18
United Facility/Professional Professional Modifier Low / Median / High Price $72.95 / $72.95 / $93.36	Professional		$72.95	$72.95	$93.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.47 / $46.00 / $62.40	Professional	26	$20.47	$46.00	$62.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.95 / $26.95 / $30.96	Professional	TC	$26.95	$26.95	$30.96
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $80.53 / $106.73	Professional		$60.27	$80.53	$106.73
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $35.93 / $50.85 / $74.25	Professional	26	$35.93	$50.85	$74.25
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $29.66 / $37.07	Professional	TC	$18.82	$29.66	$37.07