Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.67 / $277.60 / $353.28	Facility		$85.67	$277.60	$353.28
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.18 / $21.14 / $21.56	Facility	26	$12.18	$21.14	$21.56
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $73.40 / $240.58 / $566.40	Facility	TC	$73.40	$240.58	$566.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.00 / $54.40 / $134.29	Professional		$33.00	$54.40	$134.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $14.44 / $36.70	Professional	26	$7.63	$14.44	$36.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $44.56 / $299.48 / $299.48	Professional	50	$44.56	$299.48	$299.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.18 / $51.98 / $70.20	Professional	TC	$27.18	$51.98	$70.20
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 $34.19 / $62.02 / $73.03	Professional		$34.19	$62.02	$73.03
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 $47.36 / $47.36 / $47.36	Professional	50	$47.36	$47.36	$47.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.06 / $46.26 / $56.60	Professional	TC	$26.06	$46.26	$56.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.57 / $104.57 / $159.61	Professional		$104.57	$104.57	$159.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.39 / $56.39 / $56.50	Professional	26	$56.39	$56.39	$56.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.07 / $48.07 / $103.22	Professional	TC	$48.07	$48.07	$103.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $34.51 / $66.64 / $168.60	Facility		$34.51	$66.64	$168.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.62 / $70.19 / $89.04	Professional		$61.62	$70.19	$89.04
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 $52.83 / $60.84 / $76.20	Professional	TC	$52.83	$60.84	$76.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.48 / $32.34 / $64.12	Professional		$13.48	$32.34	$64.12
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 $72.20 / $84.94 / $95.36	Professional		$72.20	$84.94	$95.36
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 $57.65 / $67.81 / $74.95	Professional	TC	$57.65	$67.81	$74.95
United Facility/Professional Professional Modifier Low / Median / High Price $36.21 / $41.42 / $74.12	Professional		$36.21	$41.42	$74.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.50 / $17.00	Professional	26	$8.51	$9.50	$17.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.13 / $31.84 / $57.12	Professional	TC	$28.13	$31.84	$57.12