Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.51 / $255.00 / $418.24	Facility		$78.51	$255.00	$418.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.71 / $20.25 / $21.18	Facility	26	$11.71	$20.25	$21.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.82 / $182.05 / $475.20	Facility	TC	$53.82	$182.05	$475.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.41 / $42.15 / $84.30	Professional		$27.41	$42.15	$84.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $12.48 / $31.14	Professional	26	$7.95	$12.48	$31.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.10 / $52.24 / $252.00	Professional	50	$17.10	$52.24	$252.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.30 / $20.65 / $34.14	Professional	52	$15.30	$20.65	$34.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $29.96 / $56.39	Professional	TC	$19.46	$29.96	$56.39
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 $28.84 / $52.64 / $61.93	Professional		$28.84	$52.64	$61.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $13.38 / $16.03	Professional	26	$9.67	$13.38	$16.03
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.91 / $41.91 / $41.91	Professional	50	$41.91	$41.91	$41.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $39.26 / $45.58	Professional	TC	$21.88	$39.26	$45.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.77 / $95.77 / $113.21	Professional		$95.77	$95.77	$113.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.30 / $55.30 / $56.50	Professional	26	$55.30	$55.30	$56.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.27 / $39.27 / $57.91	Professional	TC	$39.27	$39.27	$57.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $32.67 / $58.32 / $81.92	Facility		$32.67	$58.32	$81.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $55.89 / $73.23	Professional		$47.94	$55.89	$73.23
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $14.74 / $17.23	Professional	26	$12.80	$14.74	$17.23
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.63 / $44.15 / $50.46	Professional	TC	$41.63	$44.15	$50.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.92 / $32.34 / $52.75	Professional		$12.92	$32.34	$52.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.19 / $206.06 / $311.69	Facility		$134.19	$206.06	$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 $59.98 / $70.56 / $79.89	Professional		$59.98	$70.56	$79.89
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 $46.00 / $54.12 / $60.35	Professional	TC	$46.00	$54.12	$60.35
United Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $35.72 / $68.16	Professional		$32.00	$35.72	$68.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $10.01 / $21.58	Professional	26	$8.66	$10.01	$21.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.46 / $25.26 / $47.59	Professional	TC	$22.46	$25.26	$47.59