Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $141.15 / $265.62	Professional		$99.00	$141.15	$265.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.06 / $78.94 / $124.21	Professional	26	$65.06	$78.94	$124.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.94 / $57.53 / $130.10	Professional	TC	$33.94	$57.53	$130.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.29 / $166.21 / $203.69	Professional		$140.29	$166.21	$203.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.11 / $99.64 / $102.43	Professional	26	$81.11	$99.64	$102.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.86 / $72.83 / $104.29	Professional	TC	$37.86	$72.83	$104.29
HMSA Facility/Professional Professional Modifier Low / Median / High Price $94.19 / $120.23 / $222.70	Professional		$94.19	$120.23	$222.70
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $104.25 / $109.16 / $111.89	Professional	26	$104.25	$109.16	$111.89
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $100.71 / $105.82 / $110.81	Professional	TC	$100.71	$105.82	$110.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $179.25 / $195.54 / $228.13	Professional		$179.25	$195.54	$228.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $87.47 / $95.42 / $111.33	Professional	26	$87.47	$95.42	$111.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.77 / $100.12 / $116.80	Professional	TC	$91.77	$100.12	$116.80
United Facility/Professional Professional Modifier Low / Median / High Price $166.21 / $203.69 / $287.66	Professional		$166.21	$203.69	$287.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.11 / $99.40 / $132.47	Professional	26	$81.11	$99.40	$132.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.10 / $104.29 / $155.18	Professional	TC	$85.10	$104.29	$155.18
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $124.37 / $173.34 / $229.73	Professional		$124.37	$173.34	$229.73
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $60.31 / $93.35 / $106.83	Professional	26	$60.31	$93.35	$106.83
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $84.25 / $122.91	Professional	TC	$33.88	$84.25	$122.91