Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.81 / $146.19 / $277.60	Facility		$77.81	$146.19	$277.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.87 / $27.21 / $27.44	Facility	26	$22.87	$27.21	$27.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $36.17 / $76.90	Professional		$29.19	$36.17	$76.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $12.21 / $27.21	Professional	26	$9.41	$12.21	$27.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $27.67 / $56.39	Professional	TC	$19.76	$27.67	$56.39
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 $32.21 / $56.72 / $66.73	Professional		$32.21	$56.72	$66.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $17.89 / $21.15	Professional	26	$12.01	$17.89	$21.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.51 / $45.58	Professional	TC	$21.88	$38.51	$45.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.63 / $102.63 / $110.08	Professional		$102.63	$102.63	$110.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.24 / $44.24 / $56.30	Professional	26	$44.24	$44.24	$56.30
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.78 / $53.78 / $58.39	Professional	TC	$53.78	$53.78	$58.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.29 / $64.72 / $85.24	Facility		$35.29	$64.72	$85.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $63.20 / $78.98	Professional		$47.94	$63.20	$78.98
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $19.67 / $22.91	Professional	26	$17.07	$19.67	$22.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.63 / $44.15 / $50.46	Professional	TC	$41.63	$44.15	$50.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.34 / $32.34 / $63.71	Professional		$17.34	$32.34	$63.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.19 / $206.06 / $311.69	Facility		$134.19	$206.06	$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 Professional Modifier Low / Median / High Price $64.05 / $75.34 / $86.59	Professional		$64.05	$75.34	$86.59
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $21.24 / $26.24	Professional	26	$18.05	$21.24	$26.24
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $54.12 / $60.35	Professional	TC	$46.00	$54.12	$60.35
United Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $38.00 / $68.00	Professional		$33.36	$38.00	$68.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $12.51 / $23.10	Professional	26	$10.90	$12.51	$23.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.46 / $25.84 / $46.24	Professional	TC	$22.46	$25.84	$46.24