Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $80.61 / $328.00	Professional		$71.34	$80.61	$328.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.47 / $47.02 / $104.89	Professional	26	$41.47	$47.02	$104.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.33 / $27.97 / $71.43	Professional	TC	$24.33	$27.97	$71.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.21 / $86.60 / $123.72	Professional		$54.21	$86.60	$123.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.18 / $49.46 / $69.42	Professional	26	$34.18	$49.46	$69.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.41 / $38.79 / $52.73	Professional	TC	$16.41	$38.79	$52.73
HMSA Facility/Professional Professional Modifier Low / Median / High Price $44.08 / $56.33 / $112.02	Professional		$44.08	$56.33	$112.02
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $60.20 / $63.04 / $64.62	Professional	26	$60.20	$63.04	$64.62
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $48.98 / $48.98	Professional	TC	$48.98	$48.98	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.13 / $98.98 / $115.47	Professional		$84.13	$98.98	$115.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $48.36 / $56.42	Professional	26	$41.11	$48.36	$56.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.02 / $50.62 / $59.05	Professional	TC	$43.02	$50.62	$59.05
United Facility/Professional Professional Modifier Low / Median / High Price $74.23 / $103.10 / $161.40	Professional		$74.23	$103.10	$161.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $50.38 / $119.86	Professional	26	$41.11	$50.38	$119.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.97 / $51.01 / $53.00	Professional	TC	$30.97	$51.01	$53.00
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $64.53 / $93.74 / $166.65	Professional		$64.53	$93.74	$166.65
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $36.18 / $49.92 / $83.76	Professional	26	$36.18	$49.92	$83.76
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $27.59 / $45.55 / $57.62	Professional	TC	$27.59	$45.55	$57.62