Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.39 / $281.39 / $357.35	Facility		$83.39	$281.39	$357.35
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.62 / $27.21 / $28.58	Facility	26	$15.62	$27.21	$28.58
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $45.65 / $147.05 / $346.75	Facility	TC	$45.65	$147.05	$346.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.22 / $53.92 / $90.53	Professional		$38.22	$53.92	$90.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $15.81 / $27.21	Professional	26	$10.02	$15.81	$27.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $40.09 / $64.45	Professional	TC	$25.05	$40.09	$64.45
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 $36.34 / $60.88 / $71.63	Professional		$36.34	$60.88	$71.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $17.98 / $21.15	Professional	26	$12.42	$17.98	$21.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $42.09 / $50.20	Professional	TC	$24.52	$42.09	$50.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.41 / $75.41 / $120.20	Professional		$75.41	$75.41	$120.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.51 / $61.51 / $78.08	Professional	26	$61.51	$61.51	$78.08
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.69 / $58.69 / $78.08	Professional	TC	$58.69	$58.69	$78.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.85 / $73.29 / $101.66	Facility		$38.85	$73.29	$101.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.51 / $73.13 / $92.74	Professional		$63.51	$73.13	$92.74
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $18.11 / $22.91	Professional	26	$17.07	$18.11	$22.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.43 / $49.25 / $56.28	Professional	TC	$46.43	$49.25	$56.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.34 / $32.34 / $61.81	Professional		$17.34	$32.34	$61.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $156.94 / $217.32 / $323.07	Facility		$156.94	$217.32	$323.07
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 $69.29 / $81.52 / $92.74	Professional		$69.29	$81.52	$92.74
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.63 / $21.92 / $26.24	Professional	26	$18.63	$21.92	$26.24
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $50.66 / $59.60 / $66.50	Professional	TC	$50.66	$59.60	$66.50
United Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $40.50 / $74.95	Professional		$38.61	$40.50	$74.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $12.16 / $22.63	Professional	26	$11.55	$12.16	$22.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.07 / $28.93 / $51.01	Professional	TC	$25.07	$28.93	$51.01