Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.17 / $34.17 / $34.17	Facility	26	$34.17	$34.17	$34.17
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $73.58 / $73.58 / $320.00	Facility	TC	$73.58	$73.58	$320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.67 / $53.19 / $90.56	Professional		$42.67	$53.19	$90.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $16.87 / $34.17	Professional	26	$14.49	$16.87	$34.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.17 / $36.65 / $61.84	Professional	TC	$28.17	$36.65	$61.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.33 / $69.64 / $83.98	Professional		$46.33	$69.64	$83.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $22.58 / $31.51	Professional	26	$17.39	$22.58	$31.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.47 / $47.07 / $55.37	Professional	TC	$28.47	$47.07	$55.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.19 / $147.19 / $163.38	Professional		$147.19	$147.19	$163.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.69 / $63.69 / $76.78	Professional	26	$63.69	$63.69	$76.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.41 / $70.41 / $99.70	Professional	TC	$70.41	$70.41	$99.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $71.51 / $85.81 / $104.83	Professional		$71.51	$85.81	$104.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $24.59 / $28.73	Professional	26	$21.35	$24.59	$28.73
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.18 / $57.78 / $60.82	Professional	TC	$50.18	$57.78	$60.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.77 / $32.34 / $69.83	Professional		$21.77	$32.34	$69.83
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 $78.02 / $91.79 / $104.83	Professional		$78.02	$91.79	$104.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.29 / $27.40 / $32.94	Professional	26	$23.29	$27.40	$32.94
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $54.73 / $64.39 / $71.88	Professional	TC	$54.73	$64.39	$71.88
United Facility/Professional Professional Modifier Low / Median / High Price $44.75 / $48.33 / $89.50	Professional		$44.75	$48.33	$89.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.80 / $17.11 / $30.87	Professional	26	$14.80	$17.11	$30.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.95 / $31.65 / $58.58	Professional	TC	$29.95	$31.65	$58.58