Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.26 / $98.38 / $379.00	Professional		$91.26	$98.38	$379.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.70 / $63.15 / $244.93	Professional	26	$55.70	$63.15	$244.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $32.32 / $78.37	Professional	TC	$28.10	$32.32	$78.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.22 / $102.94 / $151.38	Professional		$69.22	$102.94	$151.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.43 / $67.06 / $93.49	Professional	26	$46.43	$67.06	$93.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $45.19 / $57.84	Professional	TC	$18.64	$45.19	$57.84
HMSA Facility/Professional Professional Modifier Low / Median / High Price $46.64 / $57.86 / $131.78	Professional		$46.64	$57.86	$131.78
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $74.65 / $78.17 / $80.13	Professional	26	$74.65	$78.17	$80.13
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $53.61 / $53.61 / $53.61	Professional	TC	$53.61	$53.61	$53.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $121.10 / $141.29	Professional		$102.94	$121.10	$141.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $55.74 / $65.58 / $76.51	Professional	26	$55.74	$65.58	$76.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $47.20 / $55.52 / $64.78	Professional	TC	$47.20	$55.52	$64.78
United Facility/Professional Professional Modifier Low / Median / High Price $90.83 / $126.15 / $207.98	Professional		$90.83	$126.15	$207.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.74 / $68.31 / $162.41	Professional	26	$55.74	$68.31	$162.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.86 / $57.84 / $57.93	Professional	TC	$33.86	$57.84	$57.93
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $113.90 / $210.92	Professional		$78.23	$113.90	$210.92
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $67.62 / $121.78	Professional	26	$49.03	$67.62	$121.78
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $31.61 / $49.97 / $67.81	Professional	TC	$31.61	$49.97	$67.81