Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.16 / $229.50 / $686.40	Facility		$74.16	$229.50	$686.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.25 / $20.25 / $21.27	Facility	26	$20.25	$20.25	$21.27
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.90 / $181.80 / $815.10	Facility	TC	$53.90	$181.80	$815.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $37.47 / $71.04	Professional		$24.92	$37.47	$71.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.15 / $20.25	Professional	26	$7.03	$9.15	$20.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.52 / $47.52 / $96.04	Professional	50	$47.52	$47.52	$96.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.89 / $18.73 / $31.16	Professional	52	$13.89	$18.73	$31.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $26.87 / $53.90	Professional	TC	$17.89	$26.87	$53.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.86 / $367.78 / $603.27	Facility		$148.86	$367.78	$603.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.59 / $47.96 / $56.42	Professional		$26.59	$47.96	$56.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $13.38 / $15.74	Professional	26	$8.55	$13.38	$15.74
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $37.85	Professional	50	$37.85	$37.85	$37.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $34.34 / $40.68	Professional	TC	$19.39	$34.34	$40.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $76.97 / $76.97 / $106.12	Professional		$76.97	$76.97	$106.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.01 / $41.01 / $53.31	Professional	26	$41.01	$41.01	$53.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.66 / $23.66 / $65.11	Professional	TC	$23.66	$23.66	$65.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.10 / $52.61 / $74.78	Facility		$30.10	$52.61	$74.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $50.18 / $57.78 / $67.51	Professional		$50.18	$57.78	$67.51
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 $37.36 / $39.61 / $45.28	Professional	TC	$37.36	$39.61	$45.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.92 / $32.34 / $54.21	Professional		$12.92	$32.34	$54.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $192.42 / $261.88 / $385.48	Facility		$192.42	$261.88	$385.48
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	TC	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $65.08 / $72.97	Professional		$55.32	$65.08	$72.97
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 $41.34 / $48.64 / $53.43	Professional	TC	$41.34	$48.64	$53.43
United Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $30.68 / $57.81	Professional		$28.59	$30.68	$57.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $9.18 / $16.32	Professional	26	$8.17	$9.18	$16.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $23.18 / $41.49	Professional	TC	$20.42	$23.18	$41.49