Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.73 / $263.04 / $332.72	Facility		$75.73	$263.04	$332.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.71 / $19.45 / $19.85	Facility	26	$11.71	$19.45	$19.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $49.65 / $101.25 / $362.56	Facility	TC	$49.65	$101.25	$362.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $39.00 / $67.00	Professional		$26.46	$39.00	$67.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $11.12 / $19.45	Professional	26	$7.63	$11.12	$19.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $29.60 / $53.91	Professional	TC	$18.82	$29.60	$53.91
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 $28.84 / $49.52 / $58.26	Professional		$28.84	$49.52	$58.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.60 / $13.27 / $15.74	Professional	26	$9.60	$13.27	$15.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $36.13 / $42.12	Professional	TC	$20.22	$36.13	$42.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.87 / $95.87 / $99.22	Professional		$95.87	$95.87	$99.22
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.85 / $46.85 / $56.50	Professional	26	$46.85	$46.85	$56.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.36 / $39.36 / $52.37	Professional	TC	$39.36	$39.36	$52.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.94 / $59.64 / $79.04	Facility		$31.94	$59.64	$79.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.23 / $59.00 / $68.93	Professional		$51.23	$59.00	$68.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $14.14 / $16.52	Professional	26	$12.28	$14.14	$16.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.96 / $41.32 / $47.22	Professional	TC	$38.96	$41.32	$47.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.41 / $32.34 / $49.67	Professional		$12.41	$32.34	$49.67
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 $55.90 / $65.76 / $75.27	Professional		$55.90	$65.76	$75.27
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $15.76 / $19.54	Professional	26	$13.40	$15.76	$19.54
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 $29.95 / $33.44 / $59.84	Professional		$29.95	$33.44	$59.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.11 / $16.54	Professional	26	$8.51	$9.11	$16.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.44 / $24.32 / $43.52	Professional	TC	$21.44	$24.32	$43.52