Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.98 / $61.17 / $67.67	Professional		$45.98	$61.17	$67.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.54 / $16.64 / $16.85	Professional	26	$14.54	$16.64	$16.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.43 / $44.32 / $51.02	Professional	TC	$31.43	$44.32	$51.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $55.26 / $96.60	Professional		$42.00	$55.26	$96.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $16.94 / $25.17	Professional	26	$12.24	$16.94	$25.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.76 / $38.33 / $71.43	Professional	TC	$29.76	$38.33	$71.43
HMSA Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $78.18 / $89.42	Professional		$20.50	$78.18	$89.42
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $21.95 / $22.98 / $23.56	Professional	26	$21.95	$22.98	$23.56
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $62.90 / $65.86 / $65.86	Professional	TC	$62.90	$65.86	$65.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.09 / $53.05 / $61.89	Professional		$45.09	$53.05	$61.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $16.26 / $18.97	Professional	26	$13.82	$16.26	$18.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.27 / $36.79 / $42.92	Professional	TC	$31.27	$36.79	$42.92
United Facility/Professional Professional Modifier Low / Median / High Price $45.09 / $55.26 / $129.40	Professional		$45.09	$55.26	$129.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $16.94 / $42.84	Professional	26	$13.82	$16.94	$42.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.27 / $38.33 / $86.56	Professional	TC	$31.27	$38.33	$86.56
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $61.58 / $120.58	Professional		$45.92	$61.58	$120.58
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $17.57 / $31.86	Professional	26	$13.09	$17.57	$31.86
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $32.81 / $44.00 / $88.72	Professional	TC	$32.81	$44.00	$88.72