Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.81 / $279.89 / $351.19	Facility		$74.81	$279.89	$351.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.18 / $21.14 / $21.32	Facility	26	$12.18	$21.14	$21.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.22 / $56.74 / $329.65	Facility	TC	$39.22	$56.74	$329.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $38.93 / $74.16	Professional		$27.45	$38.93	$74.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.52 / $20.63	Professional	26	$7.33	$9.52	$20.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $29.17 / $47.29	Professional	TC	$19.14	$29.17	$47.29
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 $28.79 / $49.59 / $58.35	Professional		$28.79	$49.59	$58.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $13.97 / $16.44	Professional	26	$9.31	$13.97	$16.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $35.61 / $41.91	Professional	TC	$20.22	$35.61	$41.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.87 / $95.87 / $100.85	Professional		$95.87	$95.87	$100.85
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.01 / $41.01 / $58.56	Professional	26	$41.01	$41.01	$58.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.31 / $37.31 / $59.84	Professional	TC	$37.31	$37.31	$59.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.94 / $57.85 / $78.06	Facility		$31.94	$57.85	$78.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.31 / $60.23 / $70.37	Professional		$52.31	$60.23	$70.37
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $15.37 / $17.96	Professional	26	$13.35	$15.37	$17.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.96 / $44.86 / $55.48	Professional	TC	$38.96	$44.86	$55.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.48 / $32.34 / $56.55	Professional		$13.48	$32.34	$56.55
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 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 $57.06 / $67.13 / $76.13	Professional		$57.06	$67.13	$76.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.56 / $17.13 / $20.39	Professional	26	$14.56	$17.13	$20.39
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $42.51 / $50.01 / $55.74	Professional	TC	$42.51	$50.01	$55.74
United Facility/Professional Professional Modifier Low / Median / High Price $29.61 / $33.44 / $59.84	Professional		$29.61	$33.44	$59.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.50 / $17.00	Professional	26	$8.51	$9.50	$17.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $23.94 / $42.84	Professional	TC	$21.10	$23.94	$42.84