Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $47.03 / $152.47	Professional		$32.65	$47.03	$152.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.60 / $36.81 / $41.06	Professional	26	$15.60	$36.81	$41.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.68 / $97.42 / $111.41	Professional	TC	$12.68	$97.42	$111.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $110.38 / $179.31	Professional		$43.02	$110.38	$179.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $39.22 / $43.45	Professional	26	$24.03	$39.22	$43.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $79.41 / $135.85	Professional	TC	$19.89	$79.41	$135.85
HMSA Facility/Professional Professional Modifier Low / Median / High Price $40.38 / $142.81 / $181.16	Professional		$40.38	$142.81	$181.16
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $44.25 / $46.34 / $47.50	Professional	26	$44.25	$46.34	$47.50
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $127.65 / $133.66 / $133.66	Professional	TC	$127.65	$133.66	$133.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $48.96 / $57.12	Professional		$44.88	$48.96	$57.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.43 / $25.56 / $29.82	Professional	26	$23.43	$25.56	$29.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $23.41 / $27.31	Professional	TC	$21.46	$23.41	$27.31
United Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $51.00 / $96.20	Professional		$31.36	$51.00	$96.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $35.76 / $45.11	Professional	26	$18.39	$35.76	$45.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.97 / $24.39 / $31.84	Professional	TC	$12.97	$24.39	$31.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.32 / $49.38 / $172.00	Professional		$30.32	$49.38	$172.00
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $26.13 / $38.67	Professional	26	$16.04	$26.13	$38.67
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $14.29 / $23.27 / $133.33	Professional	TC	$14.29	$23.27	$133.33