Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.53 / $313.60 / $403.40	Facility		$78.53	$313.60	$403.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.14 / $24.63 / $25.12	Facility	26	$14.14	$24.63	$25.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $45.29 / $109.35 / $393.86	Facility	TC	$45.29	$109.35	$393.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $44.86 / $78.53	Professional		$31.73	$44.86	$78.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $11.36 / $24.63	Professional	26	$9.73	$11.36	$24.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $27.90 / $49.23	Professional	TC	$21.01	$27.90	$49.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.86 / $367.78 / $603.27	Facility		$148.86	$367.78	$603.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $50.33 / $60.70	Professional		$33.29	$50.33	$60.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $16.27 / $20.25	Professional	26	$12.01	$16.27	$20.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.28 / $34.06 / $40.39	Professional	TC	$21.28	$34.06	$40.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.98 / $103.98 / $111.58	Professional		$103.98	$103.98	$111.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.77 / $71.77 / $71.91	Professional	26	$71.77	$71.77	$71.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.07 / $32.07 / $39.81	Professional	TC	$32.07	$32.07	$39.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $34.11 / $66.00 / $79.20	Facility		$34.11	$66.00	$79.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.83 / $60.84 / $71.08	Professional		$52.83	$60.84	$71.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.48 / $17.82 / $20.82	Professional	26	$15.48	$17.82	$20.82
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 $15.70 / $32.34 / $57.29	Professional		$15.70	$32.34	$57.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $192.42 / $261.88 / $385.48	Facility		$192.42	$261.88	$385.48
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	TC	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.65 / $67.81 / $77.18	Professional		$57.65	$67.81	$77.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $19.87 / $23.75	Professional	26	$16.89	$19.87	$23.75
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 $32.11 / $34.38 / $63.63	Professional		$32.11	$34.38	$63.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $11.02 / $20.58	Professional	26	$10.47	$11.02	$20.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $23.49 / $43.47	Professional	TC	$21.65	$23.49	$43.47