Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.51 / $253.44 / $566.40	Facility		$67.51	$253.44	$566.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.71 / $19.45 / $19.62	Facility	26	$11.71	$19.45	$19.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.51 / $154.04 / $475.20	Facility	TC	$40.51	$154.04	$475.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.55 / $39.17 / $76.51	Professional		$25.55	$39.17	$76.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.15 / $19.45	Professional	26	$7.03	$9.15	$19.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.00 / $48.70 / $65.48	Professional	50	$30.00	$48.70	$65.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.24 / $19.59 / $32.15	Professional	52	$14.24	$19.59	$32.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $27.16 / $50.34	Professional	TC	$18.53	$27.16	$50.34
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 $27.29 / $50.04 / $58.87	Professional		$27.29	$50.04	$58.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $13.27 / $15.74	Professional	26	$8.55	$13.27	$15.74
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.11 / $40.11 / $40.11	Professional	50	$40.11	$40.11	$40.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $36.65 / $42.70	Professional	TC	$20.50	$36.65	$42.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $73.34 / $73.34 / $81.02	Professional		$73.34	$73.34	$81.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.31 / $53.31 / $53.42	Professional	26	$53.31	$53.31	$53.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.04 / $20.04 / $27.60	Professional	TC	$20.04	$20.04	$27.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.34 / $52.61 / $73.95	Facility		$30.34	$52.61	$73.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.23 / $59.00 / $68.93	Professional		$51.23	$59.00	$68.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $14.14 / $16.52	Professional	26	$12.28	$14.14	$16.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.96 / $41.32 / $47.22	Professional	TC	$38.96	$41.32	$47.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.41 / $32.34 / $49.67	Professional		$12.41	$32.34	$49.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $156.94 / $216.45 / $323.07	Facility		$156.94	$216.45	$323.07
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 $56.47 / $66.44 / $76.04	Professional		$56.47	$66.44	$76.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $15.76 / $19.54	Professional	26	$13.40	$15.76	$19.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $43.09 / $50.69 / $56.51	Professional	TC	$43.09	$50.69	$56.51
United Facility/Professional Professional Modifier Low / Median / High Price $29.61 / $33.82 / $60.52	Professional		$29.61	$33.82	$60.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $9.11 / $16.32	Professional	26	$8.17	$9.11	$16.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.44 / $23.46 / $43.26	Professional	TC	$21.44	$23.46	$43.26