Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.84 / $73.84 / $235.96	Professional		$73.84	$73.84	$235.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $22.69 / $51.69	Professional	26	$22.69	$22.69	$51.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.16 / $51.16 / $184.26	Professional	TC	$51.16	$51.16	$184.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.43 / $177.43 / $177.43	Professional		$177.43	$177.43	$177.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.54 / $41.54 / $41.54	Professional	26	$41.54	$41.54	$41.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.88 / $135.88 / $135.88	Professional	TC	$135.88	$135.88	$135.88
HMSA Facility/Professional Professional Modifier Low / Median / High Price $29.98 / $31.74 / $141.28	Professional		$29.98	$31.74	$141.28
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $33.68 / $35.27 / $36.15	Professional	26	$33.68	$35.27	$36.15
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $97.95 / $102.57 / $105.13	Professional	TC	$97.95	$102.57	$105.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.13 / $170.33 / $198.72	Professional		$156.13	$170.33	$198.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $39.88 / $46.52	Professional	26	$36.54	$39.88	$46.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $119.58 / $130.44 / $152.19	Professional	TC	$119.58	$130.44	$152.19
United Facility/Professional Professional Modifier Low / Median / High Price $177.43 / $194.27 / $194.27	Professional		$177.43	$194.27	$194.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.54 / $41.54 / $52.71	Professional	26	$41.54	$41.54	$52.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.88 / $135.88 / $141.56	Professional	TC	$135.88	$135.88	$141.56
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $110.63 / $197.35 / $298.56	Professional		$110.63	$197.35	$298.56
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $28.50 / $48.20 / $74.00	Professional	26	$28.50	$48.20	$74.00
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $82.24 / $149.00 / $217.66	Professional	TC	$82.24	$149.00	$217.66