Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.67 / $283.20 / $453.01	Facility		$79.67	$283.20	$453.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.69 / $22.83 / $28.78	Facility	26	$13.69	$22.83	$28.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $59.27 / $262.27 / $555.20	Facility	TC	$59.27	$262.27	$555.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.71 / $52.23 / $112.26	Professional		$27.71	$52.23	$112.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $13.19 / $34.95	Professional	26	$8.56	$13.19	$34.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.39 / $71.06 / $106.86	Professional	50	$18.39	$71.06	$106.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $39.24 / $59.42	Professional	TC	$21.33	$39.24	$59.42
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 $29.59 / $51.35 / $62.10	Professional		$29.59	$51.35	$62.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.09 / $17.75	Professional	26	$10.47	$15.09	$17.75
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.20 / $39.20 / $39.20	Professional	50	$39.20	$39.20	$39.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $34.38 / $44.36	Professional	TC	$21.33	$34.38	$44.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.79 / $104.79 / $184.93	Professional		$104.79	$104.79	$184.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.49 / $60.49 / $60.61	Professional	26	$60.49	$60.49	$60.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.18 / $44.18 / $124.44	Professional	TC	$44.18	$44.18	$124.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.85 / $63.58 / $183.19	Facility		$33.85	$63.58	$183.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.51 / $58.87 / $78.65	Professional		$55.51	$58.87	$78.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $16.59 / $18.96	Professional	26	$14.40	$16.59	$18.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.10 / $47.28 / $49.82	Professional	TC	$41.10	$47.28	$49.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.56 / $32.34 / $53.88	Professional		$14.56	$32.34	$53.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $156.94 / $216.45 / $323.07	Facility		$156.94	$216.45	$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 $61.14 / $71.93 / $80.84	Professional		$61.14	$71.93	$80.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $18.50 / $22.03	Professional	26	$15.73	$18.50	$22.03
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $45.42 / $53.43 / $58.81	Professional	TC	$45.42	$53.43	$58.81
United Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $33.56 / $63.23	Professional		$31.65	$33.56	$63.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $10.26 / $18.64	Professional	26	$9.74	$10.26	$18.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $25.08 / $44.88	Professional	TC	$19.54	$25.08	$44.88