Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $169.82 / $177.83	Professional		$93.33	$169.82	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $66.07 / $134.90	Professional	26	$34.67	$66.07	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $107.15 / $112.20	Professional	TC	$58.88	$107.15	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $154.88	Professional		$64.57	$77.62	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $32.36 / $52.48	Professional	26	$22.91	$32.36	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $45.71 / $102.33	Professional	TC	$40.74	$45.71	$102.33
HMSA Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $194.98 / $331.13	Professional		$114.82	$194.98	$331.13
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $74.13 / $128.82	Professional	26	$70.79	$74.13	$128.82
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $120.23 / $204.17	Professional	TC	$114.82	$120.23	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $151.36 / $177.83	Professional		$138.04	$151.36	$177.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $50.12 / $57.54	Professional	26	$45.71	$50.12	$57.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $102.33 / $117.49	Professional	TC	$93.33	$102.33	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $213.80	Professional		$69.18	$93.33	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $38.90 / $72.44	Professional	26	$26.92	$38.90	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $53.70 / $141.25	Professional	TC	$42.66	$53.70	$141.25
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $190.55 / $309.03	Professional		$158.49	$190.55	$309.03
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $109.65	Professional	26	$53.70	$64.57	$109.65
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $125.89 / $199.53	Professional	TC	$97.72	$125.89	$199.53