Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $72.44 / $102.33	Professional		$63.10	$72.44	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $40.74 / $61.66	Professional	26	$33.11	$40.74	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $33.88 / $52.48	Professional	TC	$19.95	$33.88	$52.48
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 $35.48 / $43.65 / $74.13	Professional	26	$35.48	$43.65	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $37.15 / $48.98	Professional	TC	$15.14	$37.15	$48.98
HMSA Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $102.33	Professional		$44.67	$56.23	$102.33
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 $43.65 / $45.71 / $45.71	Professional	TC	$43.65	$45.71	$45.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $107.15	Professional		$77.62	$91.20	$107.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $43.65 / $51.29	Professional	26	$37.15	$43.65	$51.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $48.98 / $56.23	Professional	TC	$41.69	$48.98	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $109.65	Professional		$70.79	$91.20	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $43.65 / $60.26	Professional	26	$36.31	$43.65	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $47.86 / $56.23	Professional	TC	$30.90	$47.86	$56.23
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $95.50 / $154.88	Professional		$57.54	$95.50	$154.88
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $77.62	Professional	26	$33.11	$44.67	$77.62
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $54.95	Professional	TC	$26.92	$44.67	$54.95