Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.75 / $16.76 / $16.89	Facility	26	$9.75	$16.76	$16.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $59.40 / $237.60 / $566.40	Facility	TC	$59.40	$237.60	$566.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.41 / $45.29 / $118.80	Professional		$28.41	$45.29	$118.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $10.37 / $21.32	Professional	26	$5.83	$10.37	$21.32
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.92 / $22.65 / $37.31	Professional	52	$15.92	$22.65	$37.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $43.00 / $61.30	Professional	TC	$22.57	$43.00	$61.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.70 / $56.99 / $66.36	Professional		$31.70	$56.99	$66.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $11.08 / $13.03	Professional	26	$7.36	$11.08	$13.03
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $43.71 / $43.71	Professional	50	$43.71	$43.71	$43.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.00 / $44.48 / $54.15	Professional	TC	$25.00	$44.48	$54.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.60 / $110.60 / $121.66	Professional		$110.60	$110.60	$121.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.11 / $45.11 / $45.20	Professional	26	$45.11	$45.11	$45.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.40 / $65.40 / $76.55	Professional	TC	$65.40	$65.40	$76.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.38 / $70.68 / $87.30	Professional		$61.38	$70.68	$87.30
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $12.29 / $13.43	Professional	26	$10.68	$12.29	$13.43
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.70 / $58.39 / $70.68	Professional	TC	$50.70	$58.39	$70.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $32.34 / $54.13	Professional		$10.71	$32.34	$54.13
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 $66.95 / $78.77 / $88.07	Professional		$66.95	$78.77	$88.07
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $13.70 / $16.18	Professional	26	$11.65	$13.70	$16.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $55.32 / $65.08 / $71.88	Professional	TC	$55.32	$65.08	$71.88
United Facility/Professional Professional Modifier Low / Median / High Price $32.02 / $38.00 / $68.00	Professional		$32.02	$38.00	$68.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $7.60 / $13.70	Professional	26	$6.81	$7.60	$13.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $34.64 / $54.40	Professional	TC	$26.89	$34.64	$54.40