Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.57 / $189.18 / $260.77	Professional		$100.57	$189.18	$260.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $59.50 / $59.50	Professional	26	$37.22	$59.50	$59.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.34 / $63.34 / $206.54	Professional	TC	$63.34	$63.34	$206.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.99 / $195.99 / $195.99	Professional		$195.99	$195.99	$195.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.63 / $43.63 / $43.63	Professional	26	$43.63	$43.63	$43.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $152.38 / $152.38 / $152.38	Professional	TC	$152.38	$152.38	$152.38
HMSA Facility/Professional Professional Modifier Low / Median / High Price $54.28 / $186.95 / $195.76	Professional		$54.28	$186.95	$195.76
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $60.99 / $63.86 / $91.18	Professional	26	$60.99	$63.86	$91.18
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $91.92 / $96.25 / $130.96	Professional	TC	$91.92	$96.25	$130.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $172.47 / $188.15 / $219.51	Professional		$172.47	$188.15	$219.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.39 / $41.88 / $48.86	Professional	26	$38.39	$41.88	$48.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.09 / $146.28 / $170.66	Professional	TC	$134.09	$146.28	$170.66
United Facility/Professional Professional Modifier Low / Median / High Price $195.99 / $195.99 / $214.40	Professional		$195.99	$195.99	$214.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.63 / $43.63 / $58.61	Professional	26	$43.63	$43.63	$58.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.43 / $152.38 / $155.79	Professional	TC	$33.43	$152.38	$155.79
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $99.09 / $174.42 / $246.64	Professional		$99.09	$174.42	$246.64
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $40.39 / $54.69 / $80.39	Professional	26	$40.39	$54.69	$80.39
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $43.90 / $110.86 / $190.79	Professional	TC	$43.90	$110.86	$190.79