Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.65 / $76.19 / $120.91	Professional		$72.65	$76.19	$120.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.40 / $49.50 / $191.66	Professional	26	$36.40	$49.50	$191.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $27.10 / $66.39	Professional	TC	$23.57	$27.10	$66.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.18 / $82.42 / $112.09	Professional		$51.18	$82.42	$112.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.09 / $44.01 / $74.58	Professional	26	$33.09	$44.01	$74.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.30 / $37.51 / $49.01	Professional	TC	$15.30	$37.51	$49.01
HMSA Facility/Professional Professional Modifier Low / Median / High Price $39.68 / $49.22 / $103.10	Professional		$39.68	$49.22	$103.10
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $54.90 / $57.49 / $58.92	Professional	26	$54.90	$57.49	$58.92
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.61 / $45.61 / $45.61	Professional	TC	$45.61	$45.61	$45.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.91 / $89.30 / $104.19	Professional		$75.91	$89.30	$104.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $42.25 / $49.29	Professional	26	$35.90	$42.25	$49.29
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 $66.98 / $93.03 / $143.36	Professional		$66.98	$93.03	$143.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $44.01 / $105.04	Professional	26	$35.90	$44.01	$105.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.81 / $47.54 / $49.28	Professional	TC	$28.81	$47.54	$49.28
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.21 / $84.43 / $156.36	Professional		$58.21	$84.43	$156.36
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $32.83 / $44.03 / $78.48	Professional	26	$32.83	$44.03	$78.48
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.69 / $42.35 / $55.59	Professional	TC	$26.69	$42.35	$55.59