Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.51 / $38.02 / $38.02	Facility	26	$21.51	$38.02	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $98.06 / $167.51	Professional		$59.64	$98.06	$167.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $22.96 / $41.46	Professional	26	$14.36	$22.96	$41.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $63.95 / $108.82	Professional	TC	$42.39	$63.95	$108.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.26 / $107.84 / $126.87	Professional		$64.26	$107.84	$126.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $24.88 / $29.27	Professional	26	$17.55	$24.88	$29.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.47 / $81.45 / $95.78	Professional	TC	$46.47	$81.45	$95.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $170.54 / $170.54 / $226.86	Professional		$170.54	$170.54	$226.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $105.82 / $105.82 / $105.82	Professional	26	$105.82	$105.82	$105.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.72 / $64.72 / $121.04	Professional	TC	$64.72	$64.72	$121.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $112.61 / $129.68 / $152.26	Professional		$112.61	$129.68	$152.26
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $27.66 / $29.12	Professional	26	$24.02	$27.66	$29.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.61 / $102.03 / $107.40	Professional	TC	$88.61	$102.03	$107.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $32.34 / $109.31	Professional		$24.24	$32.34	$109.31
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 Professional Modifier Low / Median / High Price $122.86 / $144.54 / $163.92	Professional		$122.86	$144.54	$163.92
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.21 / $30.83 / $36.67	Professional	26	$26.21	$30.83	$36.67
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $96.65 / $113.71 / $127.24	Professional	TC	$96.65	$113.71	$127.24
United Facility/Professional Professional Modifier Low / Median / High Price $59.57 / $72.20 / $126.17	Professional		$59.57	$72.20	$126.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.66 / $17.48 / $31.28	Professional	26	$15.66	$17.48	$31.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.91 / $51.97 / $97.92	Professional	TC	$43.91	$51.97	$97.92