Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $41.57 / $164.92	Professional		$34.95	$41.57	$164.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.92 / $15.02 / $58.99	Professional	26	$12.92	$15.02	$58.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.52 / $25.10 / $42.07	Professional	TC	$21.52	$25.10	$42.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $49.08 / $159.27	Professional		$36.86	$49.08	$159.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.39 / $17.44 / $30.05	Professional	26	$14.39	$17.44	$30.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.42 / $32.01 / $55.77	Professional	TC	$22.42	$32.01	$55.77
HMSA Facility/Professional Professional Modifier Low / Median / High Price $17.28 / $31.90 / $52.73	Professional		$17.28	$31.90	$52.73
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $18.95 / $19.84 / $20.32	Professional	26	$18.95	$19.84	$20.32
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $30.94 / $32.40	Professional	TC	$29.00	$30.94	$32.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.11 / $49.93 / $58.25	Professional		$44.11	$49.93	$58.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $16.72 / $19.50	Professional	26	$14.77	$16.72	$19.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $33.22 / $38.75	Professional	TC	$29.34	$33.22	$38.75
United Facility/Professional Professional Modifier Low / Median / High Price $31.90 / $45.57 / $65.27	Professional		$31.90	$45.57	$65.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.18 / $17.41 / $23.43	Professional	26	$12.18	$17.41	$23.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $29.89 / $41.84	Professional	TC	$19.72	$29.89	$41.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.51 / $48.96 / $82.76	Professional		$36.51	$48.96	$82.76
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.77 / $17.12 / $28.54	Professional	26	$12.77	$17.12	$28.54
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $22.67 / $31.83 / $54.20	Professional	TC	$22.67	$31.83	$54.20