Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.90 / $33.90 / $33.90	Facility	26	$33.90	$33.90	$33.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $69.06 / $69.06 / $71.15	Facility	TC	$69.06	$69.06	$71.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $46.97 / $85.17	Professional		$35.39	$46.97	$85.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.53 / $14.49 / $27.30	Professional	26	$12.53	$14.49	$27.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $28.97 / $57.87	Professional	TC	$22.85	$28.97	$57.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.67 / $65.93 / $77.56	Professional		$40.67	$65.93	$77.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.44 / $21.99 / $25.86	Professional	26	$15.44	$21.99	$25.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.24 / $42.69 / $50.78	Professional	TC	$25.24	$42.69	$50.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $159.34 / $159.34 / $176.89	Professional		$159.34	$159.34	$176.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.31 / $85.31 / $85.31	Professional	26	$85.31	$85.31	$85.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.03 / $74.03 / $74.03	Professional	TC	$74.03	$74.03	$74.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $67.25 / $77.44 / $90.49	Professional		$67.25	$77.44	$90.49
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.82 / $23.98 / $25.24	Professional	26	$20.82	$23.98	$25.24
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.43 / $55.72 / $67.25	Professional	TC	$46.43	$55.72	$67.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.19 / $32.34 / $73.16	Professional		$21.19	$32.34	$73.16
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 $73.95 / $87.00 / $99.35	Professional		$73.95	$87.00	$99.35
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $26.72 / $32.08	Professional	26	$22.71	$26.72	$32.08
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $51.24 / $60.28 / $67.27	Professional	TC	$51.24	$60.28	$67.27
United Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $44.08 / $78.87	Professional		$37.44	$44.08	$78.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $15.91 / $30.81	Professional	26	$13.62	$15.91	$30.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $29.18 / $52.36	Professional	TC	$23.82	$29.18	$52.36