Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $124.60 / $414.32	Professional		$84.00	$124.60	$414.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $50.34 / $236.10	Professional	26	$40.29	$50.34	$236.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.22 / $44.70 / $85.15	Professional	TC	$33.22	$44.70	$85.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.34 / $119.84 / $124.19	Professional		$101.34	$119.84	$124.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.61 / $56.12 / $62.40	Professional	26	$45.61	$56.12	$62.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.72 / $57.44 / $68.29	Professional	TC	$55.72	$57.44	$68.29
HMSA Facility/Professional Professional Modifier Low / Median / High Price $55.10 / $76.04 / $132.15	Professional		$55.10	$76.04	$132.15
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $60.48 / $63.33 / $63.33	Professional	26	$60.48	$63.33	$63.33
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $64.11 / $67.13 / $68.81	Professional	TC	$64.11	$67.13	$68.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.29 / $119.22 / $139.09	Professional		$109.29	$119.22	$139.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.19 / $53.66 / $62.61	Professional	26	$49.19	$53.66	$62.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $60.09 / $65.56 / $76.48	Professional	TC	$60.09	$65.56	$76.48
United Facility/Professional Professional Modifier Low / Median / High Price $99.01 / $124.19 / $163.07	Professional		$99.01	$124.19	$163.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.61 / $55.90 / $73.89	Professional	26	$45.61	$55.90	$73.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.07 / $63.87 / $89.18	Professional	TC	$52.07	$63.87	$89.18
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $79.29 / $108.88 / $140.44	Professional		$79.29	$108.88	$140.44
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.60 / $54.72 / $59.52	Professional	26	$33.60	$54.72	$59.52
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $45.69 / $55.48 / $80.93	Professional	TC	$45.69	$55.48	$80.93