Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $229.50 / $416.40	Facility		$80.45	$229.50	$416.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.16 / $20.25 / $20.42	Facility	26	$12.16	$20.25	$20.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.13 / $148.75 / $475.20	Facility	TC	$53.13	$148.75	$475.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $42.71 / $83.72	Professional		$27.73	$42.71	$83.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.40 / $20.25	Professional	26	$7.66	$9.40	$20.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.88 / $52.88 / $120.00	Professional	50	$52.88	$52.88	$120.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.46 / $20.44 / $33.81	Professional	52	$14.46	$20.44	$33.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $31.72 / $55.66	Professional	TC	$20.07	$31.72	$55.66
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 $29.16 / $52.12 / $61.09	Professional		$29.16	$52.12	$61.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $13.38 / $15.74	Professional	26	$9.32	$13.38	$15.74
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $41.47	Professional	50	$41.47	$41.47	$41.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $38.74 / $45.01	Professional	TC	$21.60	$38.74	$45.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.42 / $86.42 / $122.67	Professional		$86.42	$86.42	$122.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.12 / $42.12 / $56.50	Professional	26	$42.12	$42.12	$56.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.92 / $29.92 / $80.55	Professional	TC	$29.92	$29.92	$80.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.97 / $55.45 / $74.37	Facility		$30.97	$55.45	$74.37
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.91 / $62.07 / $72.53	Professional		$53.91	$62.07	$72.53
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $14.74 / $16.59	Professional	26	$12.80	$14.74	$16.59
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.10 / $43.59 / $49.82	Professional	TC	$41.10	$43.59	$49.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.92 / $32.34 / $58.21	Professional		$12.92	$32.34	$58.21
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 $59.39 / $69.87 / $79.12	Professional		$59.39	$69.87	$79.12
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 $45.42 / $53.43 / $59.58	Professional	TC	$45.42	$53.43	$59.58
United Facility/Professional Professional Modifier Low / Median / High Price $30.44 / $33.20 / $62.56	Professional		$30.44	$33.20	$62.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $9.19 / $17.01	Professional	26	$8.66	$9.19	$17.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $24.54 / $46.24	Professional	TC	$21.48	$24.54	$46.24