Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.66 / $238.48 / $285.12	Facility		$98.66	$238.48	$285.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.62 / $27.21 / $28.58	Facility	26	$15.62	$27.21	$28.58
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $77.08 / $208.05 / $435.60	Facility	TC	$77.08	$208.05	$435.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $55.28 / $108.36	Professional		$37.60	$55.28	$108.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $15.52 / $27.21	Professional	26	$10.02	$15.52	$27.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.08 / $46.08 / $46.08	Professional	50	$46.08	$46.08	$46.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.60 / $50.29 / $78.22	Professional	TC	$29.60	$50.29	$78.22
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 $42.65 / $71.81 / $82.51	Professional		$42.65	$71.81	$82.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $17.98 / $21.15	Professional	26	$12.37	$17.98	$21.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.27 / $52.83 / $63.33	Professional	TC	$30.27	$52.83	$63.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $138.41 / $138.41 / $168.49	Professional		$138.41	$138.41	$168.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.97 / $73.97 / $73.97	Professional	26	$73.97	$73.97	$73.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.44 / $64.44 / $94.67	Professional	TC	$64.44	$64.44	$94.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $43.77 / $93.97 / $157.13	Facility		$43.77	$93.97	$157.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $76.33 / $87.89 / $109.66	Professional		$76.33	$87.89	$109.66
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $18.11 / $20.70	Professional	26	$17.07	$18.11	$20.70
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.24 / $68.20 / $71.80	Professional	TC	$59.24	$68.20	$71.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.34 / $32.34 / $74.15	Professional		$17.34	$32.34	$74.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.19 / $206.72 / $311.69	Facility		$134.19	$206.72	$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 $83.27 / $97.96 / $109.66	Professional		$83.27	$97.96	$109.66
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.63 / $21.92 / $26.24	Professional	26	$18.63	$21.92	$26.24
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $64.63 / $76.04 / $83.42	Professional	TC	$64.63	$76.04	$83.42
United Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $48.26 / $86.35	Professional		$39.47	$48.26	$86.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $12.17 / $21.76	Professional	26	$10.89	$12.17	$21.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $35.99 / $64.59	Professional	TC	$28.59	$35.99	$64.59