Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.43 / $285.02 / $552.64	Facility		$69.43	$285.02	$552.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.17 / $19.45 / $19.85	Facility	26	$11.17	$19.45	$19.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $44.10 / $226.40 / $555.20	Facility	TC	$44.10	$226.40	$555.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $38.04 / $75.90	Professional		$22.50	$38.04	$75.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $11.89 / $27.24	Professional	26	$7.03	$11.89	$27.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $36.33 / $47.87	Professional	TC	$18.21	$36.33	$47.87
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 $26.95 / $44.84 / $53.31	Professional		$26.95	$44.84	$53.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $12.86 / $15.13	Professional	26	$8.55	$12.86	$15.13
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.49 / $36.49 / $36.49	Professional	50	$36.49	$36.49	$36.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $31.98 / $37.59	Professional	TC	$18.39	$31.98	$37.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.12 / $89.12 / $123.57	Professional		$89.12	$89.12	$123.57
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.31 / $53.31 / $53.42	Professional	26	$53.31	$53.31	$53.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.70 / $35.70 / $70.26	Professional	TC	$35.70	$35.70	$70.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $29.39 / $56.50 / $90.24	Facility		$29.39	$56.50	$90.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.96 / $52.93 / $63.18	Professional		$46.96	$52.93	$63.18
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 $34.70 / $41.64 / $46.96	Professional	TC	$34.70	$41.64	$46.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.41 / $32.34 / $45.55	Professional		$12.41	$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 $13.40 / $15.76 / $18.77	Professional	26	$13.40	$15.76	$18.77
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $37.85 / $44.53 / $49.59	Professional	TC	$37.85	$44.53	$49.59
United Facility/Professional Professional Modifier Low / Median / High Price $28.25 / $30.78 / $60.99	Professional		$28.25	$30.78	$60.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $9.11 / $16.54	Professional	26	$7.83	$9.11	$16.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $22.51 / $41.14	Professional	TC	$20.42	$22.51	$41.14