Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $67.34 / $114.61	Professional		$56.32	$67.34	$114.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.09 / $36.13 / $47.58	Professional	26	$31.09	$36.13	$47.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $23.19 / $67.03	Professional	TC	$20.19	$23.19	$67.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $71.67 / $101.38	Professional		$43.89	$71.67	$101.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.93 / $37.64 / $53.21	Professional	26	$25.93	$37.64	$53.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.15 / $33.67 / $49.48	Professional	TC	$15.15	$33.67	$49.48
HMSA Facility/Professional Professional Modifier Low / Median / High Price $41.44 / $50.57 / $93.95	Professional		$41.44	$50.57	$93.95
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $45.75 / $47.91 / $49.10	Professional	26	$45.75	$47.91	$49.10
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $46.04 / $46.04 / $46.04	Professional	TC	$46.04	$46.04	$46.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.67 / $84.31 / $98.36	Professional		$71.67	$84.31	$98.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.29 / $36.82 / $42.95	Professional	26	$31.29	$36.82	$42.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.36 / $47.50 / $55.41	Professional	TC	$40.36	$47.50	$55.41
United Facility/Professional Professional Modifier Low / Median / High Price $61.78 / $87.83 / $129.63	Professional		$61.78	$87.83	$129.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.29 / $38.35 / $91.32	Professional	26	$31.29	$38.35	$91.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.43 / $49.26 / $49.48	Professional	TC	$27.43	$49.26	$49.48
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $54.33 / $79.19 / $132.19	Professional		$54.33	$79.19	$132.19
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $27.96 / $37.70 / $68.36	Professional	26	$27.96	$37.70	$68.36
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $23.55 / $42.75 / $55.23	Professional	TC	$23.55	$42.75	$55.23