Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.83 / $213.31 / $328.24	Facility		$83.83	$213.31	$328.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.65 / $22.03 / $22.48	Facility	26	$12.65	$22.03	$22.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.36 / $129.90 / $336.30	Facility	TC	$48.36	$129.90	$336.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.42 / $42.40 / $80.31	Professional		$29.42	$42.40	$80.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $13.48 / $32.18	Professional	26	$8.46	$13.48	$32.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $32.57 / $58.65	Professional	TC	$20.96	$32.57	$58.65
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 $33.50 / $54.35 / $63.94	Professional		$33.50	$54.35	$63.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $14.57 / $17.14	Professional	26	$10.28	$14.57	$17.14
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $43.28	Professional	50	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $39.78 / $46.74	Professional	TC	$23.08	$39.78	$46.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $118.83 / $118.83 / $142.78	Professional		$118.83	$118.83	$142.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.61 / $60.61 / $60.61	Professional	26	$60.61	$60.61	$60.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.22 / $58.22 / $58.22	Professional	TC	$58.22	$58.22	$58.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.06 / $70.45 / $81.02	Facility		$33.06	$70.45	$81.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $65.76 / $76.83	Professional		$57.11	$65.76	$76.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $15.98 / $16.82	Professional	26	$13.88	$15.98	$16.82
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.23 / $49.78 / $52.40	Professional	TC	$43.23	$49.78	$52.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $32.34 / $61.76	Professional		$14.05	$32.34	$61.76
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 $62.31 / $73.30 / $83.15	Professional		$62.31	$73.30	$83.15
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $17.80 / $21.26	Professional	26	$15.14	$17.80	$21.26
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $47.17 / $55.49 / $61.89	Professional	TC	$47.17	$55.49	$61.89
United Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $36.86 / $65.97	Professional		$30.97	$36.86	$65.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $9.88 / $17.68	Professional	26	$9.19	$9.88	$17.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $26.98 / $46.41	Professional	TC	$21.78	$26.98	$46.41