Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $99.03 / $309.82	Professional		$68.06	$99.03	$309.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $23.58 / $46.77	Professional	26	$17.82	$23.58	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.22 / $68.56 / $99.16	Professional	TC	$50.22	$68.56	$99.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $83.56 / $102.40	Professional		$67.55	$83.56	$102.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $21.20 / $25.98	Professional	26	$18.45	$21.20	$25.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $62.35 / $76.41	Professional	TC	$49.10	$62.35	$76.41
HMSA Facility/Professional Professional Modifier Low / Median / High Price $24.25 / $206.68 / $236.03	Professional		$24.25	$206.68	$236.03
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $25.73 / $26.94 / $27.61	Professional	26	$25.73	$26.94	$27.61
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $171.65 / $179.74 / $179.76	Professional	TC	$171.65	$179.74	$179.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.38 / $98.30 / $114.69	Professional		$84.38	$98.30	$114.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.40 / $24.94 / $29.09	Professional	26	$21.40	$24.94	$29.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $62.96 / $73.36 / $85.58	Professional	TC	$62.96	$73.36	$85.58
United Facility/Professional Professional Modifier Low / Median / High Price $102.40 / $127.83 / $167.02	Professional		$102.40	$127.83	$167.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $25.98 / $32.72	Professional	26	$14.49	$25.98	$32.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.63 / $76.41 / $142.88	Professional	TC	$53.63	$76.41	$142.88
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $82.12 / $82.12 / $83.72	Professional		$82.12	$82.12	$83.72
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $20.92 / $20.92 / $21.38	Professional	26	$20.92	$20.92	$21.38
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $61.20 / $61.20 / $62.33	Professional	TC	$61.20	$61.20	$62.33