Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.63 / $244.64 / $329.99	Facility		$77.63	$244.64	$329.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.82 / $26.41 / $27.75	Facility	26	$15.82	$26.41	$27.75
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.90 / $238.85 / $388.09	Facility	TC	$53.90	$238.85	$388.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $51.05 / $144.00	Professional		$28.74	$51.05	$144.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $17.80 / $43.35	Professional	26	$9.77	$17.80	$43.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.96 / $34.78 / $51.64	Professional	TC	$18.96	$34.78	$51.64
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 $31.85 / $52.04 / $61.22	Professional		$31.85	$52.04	$61.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $17.46 / $20.54	Professional	26	$12.01	$17.46	$20.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.84 / $34.34 / $40.39	Professional	TC	$19.84	$34.34	$40.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.53 / $102.53 / $218.57	Professional		$102.53	$102.53	$218.57
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.86 / $69.86 / $69.86	Professional	26	$69.86	$69.86	$69.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.67 / $32.67 / $168.30	Professional	TC	$32.67	$32.67	$168.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.36 / $67.51 / $243.00	Facility		$31.36	$67.51	$243.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.91 / $62.07 / $78.90	Professional		$53.91	$62.07	$78.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.55 / $19.05 / $20.05	Professional	26	$16.55	$19.05	$20.05
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $43.02 / $45.28	Professional	TC	$37.36	$43.02	$45.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $32.34 / $58.56	Professional		$16.82	$32.34	$58.56
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 $58.81 / $69.19 / $78.90	Professional		$58.81	$69.19	$78.90
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $21.24 / $25.47	Professional	26	$18.05	$21.24	$25.47
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $40.76 / $47.95 / $53.43	Professional	TC	$40.76	$47.95	$53.43
United Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $34.96 / $61.71	Professional		$29.27	$34.96	$61.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $11.79 / $22.38	Professional	26	$10.55	$11.79	$22.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.72 / $23.17 / $44.63	Professional	TC	$18.72	$23.17	$44.63