Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.06 / $149.01 / $159.76	Professional		$92.06	$149.01	$159.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $15.76 / $16.09	Professional	26	$12.60	$15.76	$16.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.45 / $121.04 / $132.91	Professional	TC	$79.45	$121.04	$132.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.76 / $121.55 / $181.51	Professional		$86.76	$121.55	$181.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $14.50 / $18.46	Professional	26	$12.22	$14.50	$18.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.54 / $107.59 / $163.05	Professional	TC	$74.54	$107.59	$163.05
HMSA Facility/Professional Professional Modifier Low / Median / High Price $20.53 / $161.80 / $176.51	Professional		$20.53	$161.80	$176.51
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $20.99 / $21.51	Professional	26	$20.05	$20.99	$21.51
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $148.02 / $148.43 / $154.99	Professional	TC	$148.02	$148.43	$154.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $159.72 / $203.29	Professional		$159.72	$159.72	$203.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.25 / $16.25 / $20.68	Professional	26	$16.25	$16.25	$20.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $143.47 / $143.47 / $182.62	Professional	TC	$143.47	$143.47	$182.62
United Facility/Professional Professional Modifier Low / Median / High Price $86.21 / $148.11 / $192.11	Professional		$86.21	$148.11	$192.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $18.46 / $24.20	Professional	26	$14.23	$18.46	$24.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.39 / $140.88 / $167.91	Professional	TC	$87.39	$140.88	$167.91
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $89.65 / $108.86 / $170.97	Professional		$89.65	$108.86	$170.97
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $11.29 / $17.09 / $23.26	Professional	26	$11.29	$17.09	$23.26
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $72.81 / $95.15 / $147.71	Professional	TC	$72.81	$95.15	$147.71