Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.78 / $230.25 / $558.66	Facility		$61.78	$230.25	$558.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.73 / $22.03 / $23.14	Facility	26	$12.73	$22.03	$23.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.69 / $277.60 / $663.62	Facility	TC	$39.69	$277.60	$663.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $28.91 / $59.18	Professional		$17.78	$28.91	$59.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $12.39 / $34.00	Professional	26	$8.08	$12.39	$34.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $19.01 / $33.39	Professional	TC	$9.69	$19.01	$33.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.60 / $273.04 / $498.63	Facility		$110.60	$273.04	$498.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.92 / $39.78 / $46.80	Professional		$20.92	$39.78	$46.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $14.43 / $17.14	Professional	26	$10.07	$14.43	$17.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.58 / $25.22 / $29.67	Professional	TC	$12.58	$25.22	$29.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $59.82 / $59.82 / $81.02	Professional		$59.82	$59.82	$81.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.49 / $51.49 / $60.49	Professional	26	$51.49	$51.49	$60.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.53 / $20.53 / $20.53	Professional	TC	$20.53	$20.53	$20.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $22.16 / $51.92 / $226.40	Facility		$22.16	$51.92	$226.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $44.15 / $56.01	Professional		$27.75	$44.15	$56.01
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $15.98 / $44.15	Professional	26	$13.88	$15.98	$44.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $33.64 / $50.46	Professional	TC	$16.82	$33.64	$50.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.62 / $32.34 / $45.16	Professional		$13.62	$32.34	$45.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.19 / $211.17 / $311.69	Facility		$134.19	$211.17	$311.69
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $156.94 / $156.94 / $156.94	Facility	26	$156.94	$156.94	$156.94
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $156.94 / $156.94 / $156.94	Facility	TC	$156.94	$156.94	$156.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $52.74 / $60.85	Professional		$44.83	$52.74	$60.85
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.56 / $17.13 / $21.26	Professional	26	$14.56	$17.13	$21.26
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $30.28 / $35.61 / $39.59	Professional	TC	$30.28	$35.61	$39.59
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $27.36 / $48.95	Professional		$19.05	$27.36	$48.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $9.88 / $17.98	Professional	26	$8.85	$9.88	$17.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.21 / $16.60 / $26.56	Professional	TC	$10.21	$16.60	$26.56