Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.82 / $56.52 / $97.47	Professional		$42.82	$56.52	$97.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.59 / $23.78 / $31.07	Professional	26	$20.59	$23.78	$31.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $21.88 / $66.39	Professional	TC	$19.05	$21.88	$66.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.18 / $60.42 / $77.87	Professional		$34.18	$60.42	$77.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $24.82 / $34.47	Professional	26	$17.11	$24.82	$34.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.15 / $30.74 / $49.01	Professional	TC	$15.15	$30.74	$49.01
HMSA Facility/Professional Professional Modifier Low / Median / High Price $28.43 / $43.17 / $77.09	Professional		$28.43	$43.17	$77.09
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $30.45 / $31.88 / $32.68	Professional	26	$30.45	$31.88	$32.68
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.20 / $45.20 / $45.20	Professional	TC	$45.20	$45.20	$45.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $71.09 / $82.94	Professional		$60.42	$71.09	$82.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $24.05 / $28.06	Professional	26	$20.44	$24.05	$28.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.99 / $47.05 / $54.89	Professional	TC	$39.99	$47.05	$54.89
United Facility/Professional Professional Modifier Low / Median / High Price $49.99 / $74.05 / $98.64	Professional		$49.99	$74.05	$98.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $25.05 / $60.32	Professional	26	$20.44	$25.05	$60.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.45 / $47.09 / $49.01	Professional	TC	$28.45	$47.09	$49.01
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.17 / $66.58 / $98.59	Professional		$46.17	$66.58	$98.59
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $18.46 / $24.89 / $45.08	Professional	26	$18.46	$24.89	$45.08
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $42.35 / $54.73	Professional	TC	$21.76	$42.35	$54.73