Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.43 / $261.36 / $305.45	Facility		$69.43	$261.36	$305.45
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.87 / $20.25 / $20.66	Facility	26	$17.87	$20.25	$20.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $49.18 / $234.53 / $566.40	Facility	TC	$49.18	$234.53	$566.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.57 / $38.52 / $69.43	Professional		$25.57	$38.52	$69.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $9.77 / $20.25	Professional	26	$6.74	$9.77	$20.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $24.48 / $47.11	Professional	TC	$18.82	$24.48	$47.11
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 $26.92 / $44.84 / $52.75	Professional		$26.92	$44.84	$52.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.16 / $13.38 / $15.74	Professional	26	$8.16	$13.38	$15.74
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.11 / $35.11 / $35.11	Professional	50	$35.11	$35.11	$35.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.76 / $31.35 / $37.01	Professional	TC	$18.76	$31.35	$37.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.42 / $86.42 / $142.61	Professional		$86.42	$86.42	$142.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.26 / $51.26 / $51.37	Professional	26	$51.26	$51.26	$51.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.04 / $35.04 / $91.35	Professional	TC	$35.04	$35.04	$91.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $29.02 / $54.37 / $70.02	Facility		$29.02	$54.37	$70.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.96 / $54.07 / $63.18	Professional		$46.96	$54.07	$63.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $14.74 / $15.80	Professional	26	$12.80	$14.74	$15.80
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.15 / $36.34 / $41.40	Professional	TC	$34.15	$36.34	$41.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.92 / $32.34 / $45.55	Professional		$12.92	$32.34	$45.55
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 $51.24 / $60.28 / $68.34	Professional		$51.24	$60.28	$68.34
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.97 / $16.44 / $19.54	Professional	26	$13.97	$16.44	$19.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $37.26 / $43.84 / $48.82	Professional	TC	$37.26	$43.84	$48.82
United Facility/Professional Professional Modifier Low / Median / High Price $28.87 / $30.40 / $55.04	Professional		$28.87	$30.40	$55.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $9.11 / $16.32	Professional	26	$7.83	$9.11	$16.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $21.44 / $38.08	Professional	TC	$20.21	$21.44	$38.08