Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $44.67 / $89.13	Professional		$38.90	$44.67	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.02 / $25.12	Professional	26	$10.00	$12.02	$25.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $32.36 / $44.67	Professional	TC	$28.18	$32.36	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $131.83	Professional		$45.71	$53.70	$131.83
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 $33.11 / $40.74 / $100.00	Professional	TC	$33.11	$40.74	$100.00
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $56.23 / $302.00	Professional		$18.62	$56.23	$302.00
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 $40.74 / $42.66 / $42.66	Professional	TC	$40.74	$42.66	$42.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $83.18	Professional		$54.95	$66.07	$83.18
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 $42.66 / $51.29 / $64.57	Professional	TC	$42.66	$51.29	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $81.28	Professional		$39.81	$54.95	$81.28
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 $27.54 / $39.81 / $57.54	Professional	TC	$27.54	$39.81	$57.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $239.88	Professional		$41.69	$57.54	$239.88
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 $31.62 / $42.66 / $72.44	Professional	TC	$31.62	$42.66	$72.44