Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.08 / $70.43 / $289.88	Professional		$62.08	$70.43	$289.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $20.53 / $92.12	Professional	26	$17.30	$20.53	$92.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.64 / $57.37 / $136.00	Professional	TC	$45.64	$57.37	$136.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.10 / $20.10 / $20.10	Facility	26	$20.10	$20.10	$20.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.42 / $67.27 / $132.27	Professional		$46.42	$67.27	$132.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $21.63 / $39.40	Professional	26	$16.71	$21.63	$39.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.71 / $45.29 / $92.86	Professional	TC	$29.71	$45.29	$92.86
HMSA Facility/Professional Professional Modifier Low / Median / High Price $28.44 / $93.70 / $99.10	Professional		$28.44	$93.70	$99.10
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $29.44 / $30.83 / $31.60	Professional	26	$29.44	$30.83	$31.60
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $64.26 / $67.29 / $67.29	Professional	TC	$64.26	$67.29	$67.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $64.25 / $74.95	Professional		$58.89	$64.25	$74.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.03 / $20.76 / $24.22	Professional	26	$19.03	$20.76	$24.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.85 / $43.48 / $50.72	Professional	TC	$39.85	$43.48	$50.72
United Facility/Professional Professional Modifier Low / Median / High Price $49.08 / $66.93 / $90.14	Professional		$49.08	$66.93	$90.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.04 / $21.63 / $29.10	Professional	26	$14.04	$21.63	$29.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.95 / $45.29 / $61.04	Professional	TC	$36.95	$45.29	$61.04
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $51.08 / $74.51 / $150.19	Professional		$51.08	$74.51	$150.19
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $22.50 / $38.56	Professional	26	$16.48	$22.50	$38.56
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $34.59 / $50.46 / $84.16	Professional	TC	$34.59	$50.46	$84.16