Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $575.44 / $870.96	Professional		$83.18	$575.44	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $43.65 / $1,230.27	Professional	26	$22.91	$43.65	$1,230.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $67.61 / $125.89	Professional	TC	$46.77	$67.61	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $37.15 / $151.36	Professional		$36.31	$37.15	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.79 / $35.48	Professional	26	$14.45	$14.79	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $22.91 / $114.82	Professional	TC	$21.38	$22.91	$114.82
HMSA Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $138.04	Professional		$83.18	$117.49	$138.04
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $38.90 / $39.81	Professional	26	$37.15	$38.90	$39.81
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $97.72 / $97.72	Professional	TC	$93.33	$97.72	$97.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $141.25 / $165.96	Professional		$131.83	$141.25	$165.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $33.88 / $39.81	Professional	26	$30.90	$33.88	$39.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $107.15 / $125.89	Professional	TC	$100.00	$107.15	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $50.12 / $158.49	Professional		$43.65	$50.12	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $17.78 / $47.86	Professional	26	$17.38	$17.78	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $114.82	Professional	TC	$25.70	$33.11	$114.82
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $190.55	Professional		$104.71	$158.49	$190.55
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $42.66 / $64.57	Professional	26	$33.11	$42.66	$64.57
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $123.03 / $141.25	Professional	TC	$66.07	$123.03	$141.25