Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $158.49	Professional		$36.31	$53.70	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $27.54	Professional	26	$8.91	$12.02	$27.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $60.26	Professional	TC	$25.70	$37.15	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $69.18 / $158.49	Professional		$46.77	$69.18	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.85 / $26.92	Professional	26	$10.47	$15.85	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $52.48 / $95.50	Professional	TC	$35.48	$52.48	$95.50
HMSA Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $91.20 / $102.33	Professional		$22.91	$91.20	$102.33
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.95 / $20.42	Professional	26	$19.05	$19.95	$20.42
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $75.86 / $75.86	Professional	TC	$72.44	$75.86	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $72.44	Professional		$47.86	$57.54	$72.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $12.88 / $15.85	Professional	26	$10.72	$12.88	$15.85
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $44.67 / $56.23	Professional	TC	$37.15	$44.67	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $60.26 / $107.15	Professional		$45.71	$60.26	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.49 / $25.70	Professional	26	$10.72	$13.49	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $45.71 / $79.43	Professional	TC	$33.88	$45.71	$79.43
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $257.04	Professional		$37.15	$54.95	$257.04
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $20.42	Professional	26	$9.12	$12.30	$20.42
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.90 / $64.57	Professional	TC	$28.18	$38.90	$64.57