Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.78 / $38.78 / $38.78	Facility	26	$38.78	$38.78	$38.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $62.65 / $123.26	Professional		$51.49	$62.65	$123.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $16.52 / $35.36	Professional	26	$14.36	$16.52	$35.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $46.41 / $91.62	Professional	TC	$37.11	$46.41	$91.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.50 / $94.83 / $111.57	Professional		$58.50	$94.83	$111.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $24.88 / $29.27	Professional	26	$17.55	$24.88	$29.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.71 / $69.95 / $81.36	Professional	TC	$40.71	$69.95	$81.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $206.61 / $206.61 / $226.02	Professional		$206.61	$206.61	$226.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.97 / $102.97 / $102.97	Professional	26	$102.97	$102.97	$102.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $103.64 / $103.64 / $103.64	Professional	TC	$103.64	$103.64	$103.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $99.26 / $114.30 / $133.56	Professional		$99.26	$114.30	$133.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $27.66 / $29.12	Professional	26	$24.02	$27.66	$29.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.26 / $86.66 / $91.22	Professional	TC	$75.26	$86.66	$91.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $32.34 / $107.48	Professional		$24.24	$32.34	$107.48
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 Professional Modifier Low / Median / High Price $108.30 / $127.41 / $144.69	Professional		$108.30	$127.41	$144.69
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.21 / $30.83 / $36.67	Professional	26	$26.21	$30.83	$36.67
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $82.10 / $96.59 / $108.02	Professional	TC	$82.10	$96.59	$108.02
United Facility/Professional Professional Modifier Low / Median / High Price $54.12 / $63.08 / $112.88	Professional		$54.12	$63.08	$112.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.66 / $17.10 / $30.60	Professional	26	$15.66	$17.10	$30.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.46 / $45.98 / $81.09	Professional	TC	$38.46	$45.98	$81.09