Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $56.23 / $93.33	Professional		$48.98	$56.23	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.02 / $35.48	Professional	26	$10.00	$12.02	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $42.66 / $60.26	Professional	TC	$37.15	$42.66	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $165.96	Professional		$57.54	$67.61	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.45 / $31.62	Professional	26	$12.02	$14.45	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $54.95 / $134.90	Professional	TC	$44.67	$54.95	$134.90
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $72.44 / $81.28	Professional		$18.20	$72.44	$81.28
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.85 / $16.22	Professional	26	$15.14	$15.85	$16.22
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $60.26 / $60.26	Professional	TC	$57.54	$60.26	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $107.15	Professional		$70.79	$85.11	$107.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.79 / $18.62	Professional	26	$12.30	$14.79	$18.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $70.79 / $87.10	Professional	TC	$58.88	$70.79	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.61 / $102.33	Professional		$50.12	$67.61	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.45 / $22.91	Professional	26	$11.22	$14.45	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $53.70 / $81.28	Professional	TC	$38.02	$53.70	$81.28
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $398.11	Professional		$52.48	$72.44	$398.11
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $23.99	Professional	26	$10.72	$14.45	$23.99
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $56.23 / $95.50	Professional	TC	$41.69	$56.23	$95.50