Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $63.10 / $100.00	Professional		$53.70	$63.10	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.84 / $61.66	Professional	26	$23.99	$28.84	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.88 / $47.86	Professional	TC	$28.84	$33.88	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $74.13 / $257.04	Professional		$63.10	$74.13	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $33.88 / $72.44	Professional	26	$27.54	$33.88	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $41.69 / $158.49	Professional	TC	$33.11	$41.69	$158.49
HMSA Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $245.47 / $295.12	Professional		$44.67	$245.47	$295.12
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $38.90	Professional	26	$36.31	$38.02	$38.90
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $218.78 / $218.78	Professional	TC	$208.93	$218.78	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $91.20 / $114.82	Professional		$75.86	$91.20	$114.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $35.48 / $43.65	Professional	26	$29.51	$35.48	$43.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $56.23 / $69.18	Professional	TC	$46.77	$56.23	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $128.82	Professional		$51.29	$77.62	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.88 / $52.48	Professional	26	$25.12	$33.88	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $63.10	Professional	TC	$26.92	$41.69	$63.10
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $77.62 / $134.90	Professional		$58.88	$77.62	$134.90
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.11 / $54.95	Professional	26	$25.12	$33.11	$54.95
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $44.67 / $75.86	Professional	TC	$33.11	$44.67	$75.86