Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $131.83	Professional		$66.07	$81.28	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $39.81 / $177.83	Professional	26	$33.11	$39.81	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $41.69 / $61.66	Professional	TC	$19.95	$41.69	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $83.18 / $120.23	Professional		$51.29	$83.18	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $63.10	Professional	26	$33.88	$44.67	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $37.15 / $57.54	Professional	TC	$17.78	$37.15	$57.54
HMSA Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $112.20	Professional		$51.29	$66.07	$112.20
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $57.54 / $58.88	Professional	26	$54.95	$57.54	$58.88
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $53.70 / $53.70	Professional	TC	$51.29	$53.70	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $120.23	Professional		$87.10	$102.33	$120.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $45.71 / $52.48	Professional	26	$38.90	$45.71	$52.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $56.23 / $66.07	Professional	TC	$47.86	$56.23	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $120.23	Professional		$74.13	$100.00	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $44.67 / $107.15	Professional	26	$37.15	$44.67	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $52.48 / $57.54	Professional	TC	$30.90	$52.48	$57.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $104.71 / $154.88	Professional		$64.57	$104.71	$154.88
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $45.71 / $81.28	Professional	26	$33.11	$45.71	$81.28
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $53.70 / $66.07	Professional	TC	$26.92	$53.70	$66.07