Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.59 / $85.40 / $328.24	Facility		$68.59	$85.40	$328.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.65 / $22.03 / $22.94	Facility	26	$12.65	$22.03	$22.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $45.65 / $63.35 / $343.20	Facility	TC	$45.65	$63.35	$343.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $41.65 / $71.77	Professional		$33.50	$41.65	$71.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.64 / $12.41 / $31.16	Professional	26	$9.64	$12.41	$31.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $30.12 / $53.24	Professional	TC	$22.87	$30.12	$53.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.86 / $367.78 / $603.27	Facility		$148.86	$367.78	$603.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.52 / $54.87 / $65.98	Professional		$35.52	$54.87	$65.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.57 / $14.57 / $22.77	Professional	26	$11.57	$14.57	$22.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.72 / $40.29 / $47.42	Professional	TC	$22.72	$40.29	$47.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.50 / $86.50 / $106.68	Professional		$86.50	$86.50	$106.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.13 / $80.13 / $80.13	Professional	26	$80.13	$80.13	$80.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.37 / $6.37 / $26.55	Professional	TC	$6.37	$6.37	$26.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $37.20 / $71.31 / $85.42	Facility		$37.20	$71.31	$85.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $66.37 / $77.54	Professional		$53.04	$66.37	$77.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $15.98 / $18.67	Professional	26	$13.88	$15.98	$18.67
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.76 / $46.41 / $53.04	Professional	TC	$43.76	$46.41	$53.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $32.34 / $49.55	Professional		$14.05	$32.34	$49.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $192.42 / $261.88 / $385.48	Facility		$192.42	$261.88	$385.48
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	TC	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $62.88 / $73.98 / $83.91	Professional		$62.88	$73.98	$83.91
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $17.80 / $21.26	Professional	26	$15.14	$17.80	$21.26
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $47.74 / $56.17 / $62.66	Professional	TC	$47.74	$56.17	$62.66
United Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $38.00 / $71.04	Professional		$36.09	$38.00	$71.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.89 / $21.96	Professional	26	$10.47	$12.89	$21.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.62 / $26.98 / $48.27	Professional	TC	$25.62	$26.98	$48.27