Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $177.83	Professional		$51.29	$64.57	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $177.83	Professional	26	$15.85	$20.89	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $43.65 / $67.61	Professional	TC	$30.90	$43.65	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $97.72	Professional		$66.07	$77.62	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $27.54	Professional	26	$20.89	$22.91	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $54.95 / $69.18	Professional	TC	$47.86	$54.95	$69.18
HMSA Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $74.13 / $79.43	Professional		$26.92	$74.13	$79.43
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $22.91 / $23.44	Professional	26	$21.88	$22.91	$23.44
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $54.95 / $54.95	Professional	TC	$52.48	$54.95	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $85.11 / $107.15	Professional		$79.43	$85.11	$107.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $28.84	Professional	26	$20.89	$22.91	$28.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $63.10 / $79.43	Professional	TC	$57.54	$63.10	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $81.28	Professional		$60.26	$75.86	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $21.88 / $25.70	Professional	26	$17.38	$21.88	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $53.70 / $57.54	Professional	TC	$42.66	$53.70	$57.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $91.20	Professional		$52.48	$70.79	$91.20
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $20.89 / $24.55	Professional	26	$13.80	$20.89	$24.55
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $50.12 / $67.61	Professional	TC	$38.02	$50.12	$67.61