Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.14 / $283.20 / $439.02	Facility		$82.14	$283.20	$439.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.63 / $20.36 / $21.38	Facility	26	$11.63	$20.36	$21.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $61.73 / $237.60 / $555.20	Facility	TC	$61.73	$237.60	$555.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $55.64 / $116.12	Professional		$28.64	$55.64	$116.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $12.40 / $33.36	Professional	26	$7.50	$12.40	$33.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.78 / $89.43 / $121.31	Professional	50	$63.78	$89.43	$121.31
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.97 / $20.62 / $34.52	Professional	52	$15.97	$20.62	$34.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $44.31 / $73.78	Professional	TC	$21.32	$44.31	$73.78
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 $30.59 / $52.72 / $62.02	Professional		$30.59	$52.72	$62.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $13.45 / $15.83	Professional	26	$9.31	$13.45	$15.83
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.56 / $40.56 / $40.56	Professional	50	$40.56	$40.56	$40.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.28 / $37.90 / $45.58	Professional	TC	$21.28	$37.90	$45.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.29 / $61.29 / $95.52	Professional		$61.29	$61.29	$95.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.56 / $63.56 / $63.69	Professional	26	$63.56	$63.56	$63.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.96 / $31.96 / $63.69	Professional	TC	$31.96	$31.96	$63.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $32.86 / $63.90 / $158.97	Facility		$32.86	$63.90	$158.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.15 / $58.46 / $73.23	Professional		$44.15	$58.46	$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 $12.97 / $32.34 / $58.83	Professional		$12.97	$32.34	$58.83
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 / $79.98	Professional		$59.98	$70.56	$79.98
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.97 / $16.44 / $19.63	Professional	26	$13.97	$16.44	$19.63
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 $32.34 / $34.96 / $66.58	Professional		$32.34	$34.96	$66.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $9.11 / $16.60	Professional	26	$8.17	$9.11	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.47 / $24.54 / $46.24	Professional	TC	$23.47	$24.54	$46.24