Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.95 / $43.42 / $111.41	Professional		$40.95	$43.42	$111.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.89 / $23.78 / $26.91	Professional	26	$17.89	$23.78	$26.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.17 / $19.71 / $57.56	Professional	TC	$17.17	$19.71	$57.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.18 / $52.39 / $74.76	Professional		$29.18	$52.39	$74.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.25 / $21.69 / $34.47	Professional	26	$16.25	$21.69	$34.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.93 / $27.91 / $42.50	Professional	TC	$12.93	$27.91	$42.50
HMSA Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $37.54 / $71.47	Professional		$28.68	$37.54	$71.47
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $30.70 / $32.15 / $32.96	Professional	26	$30.70	$32.15	$32.96
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $39.32 / $39.32 / $39.32	Professional	TC	$39.32	$39.32	$39.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.39 / $61.63 / $71.90	Professional		$52.39	$61.63	$71.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $20.82 / $24.29	Professional	26	$17.70	$20.82	$24.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.68 / $40.79 / $47.60	Professional	TC	$34.68	$40.79	$47.60
United Facility/Professional Professional Modifier Low / Median / High Price $43.84 / $64.20 / $84.40	Professional		$43.84	$64.20	$84.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $21.69 / $51.72	Professional	26	$17.70	$21.69	$51.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.66 / $40.99 / $42.50	Professional	TC	$23.66	$40.99	$42.50
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $40.67 / $58.70 / $96.53	Professional		$40.67	$58.70	$96.53
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $21.77 / $38.65	Professional	26	$16.23	$21.77	$38.65
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $19.53 / $36.72 / $48.36	Professional	TC	$19.53	$36.72	$48.36