Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.42 / $285.30 / $445.80	Facility		$77.42	$285.30	$445.80
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 $47.28 / $237.60 / $445.80	Facility	TC	$47.28	$237.60	$445.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $48.12 / $125.15	Professional		$25.20	$48.12	$125.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $12.99 / $27.64	Professional	26	$7.50	$12.99	$27.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.14 / $79.14 / $119.13	Professional	50	$79.14	$79.14	$119.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $42.04 / $56.27	Professional	TC	$23.51	$42.04	$56.27
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 $33.83 / $49.59 / $58.35	Professional		$33.83	$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 50 Low / Median / High Price $38.75 / $38.75 / $38.75	Professional	50	$38.75	$38.75	$38.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.52 / $34.93 / $42.70	Professional	TC	$24.52	$34.93	$42.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.95 / $110.95 / $156.87	Professional		$110.95	$110.95	$156.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.44 / $58.44 / $58.56	Professional	26	$58.44	$58.44	$58.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.39 / $52.39 / $98.43	Professional	TC	$52.39	$52.39	$98.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $32.94 / $65.06 / $104.69	Facility		$32.94	$65.06	$104.69
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 / $45.03 / $55.48	Professional	TC	$38.96	$45.03	$55.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.48 / $32.34 / $50.75	Professional		$13.48	$32.34	$50.75
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 $57.65 / $67.81 / $76.13	Professional		$57.65	$67.81	$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 $43.09 / $50.69 / $55.74	Professional	TC	$43.09	$50.69	$55.74
United Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $34.72 / $63.19	Professional		$31.40	$34.72	$63.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.02 / $17.00	Professional	26	$8.51	$9.02	$17.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.38 / $26.21 / $48.51	Professional	TC	$22.38	$26.21	$48.51