Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.97 / $45.30 / $55.51	Facility	26	$39.97	$45.30	$55.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $98.85 / $145.56	Professional		$73.44	$98.85	$145.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.22 / $53.95 / $78.02	Professional	TC	$34.22	$53.95	$78.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.21 / $94.95 / $132.63	Professional		$82.21	$94.95	$132.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $49.65 / $71.41	Professional	TC	$19.28	$49.65	$71.41
HMSA Facility/Professional Professional Modifier Low / Median / High Price $58.06 / $75.03 / $154.62	Professional		$58.06	$75.03	$154.62
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $62.23 / $82.42 / $86.30	Professional	TC	$62.23	$82.42	$86.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.40 / $111.71 / $130.33	Professional		$102.40	$111.71	$130.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.85 / $53.29 / $62.17	Professional	26	$48.85	$53.29	$62.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $53.55 / $58.42 / $68.15	Professional	TC	$53.55	$58.42	$68.15
United Facility/Professional Professional Modifier Low / Median / High Price $94.95 / $116.36 / $163.72	Professional		$94.95	$116.36	$163.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.65 / $60.85 / $86.79	Professional	TC	$49.65	$60.85	$86.79
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $129.58 / $140.94	Professional		$72.09	$129.58	$140.94
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $16.62 / $73.59 / $80.04	Professional	TC	$16.62	$73.59	$80.04