Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.01 / $247.28 / $283.20	Facility		$72.01	$247.28	$283.20
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 $49.48 / $215.10 / $336.30	Facility	TC	$49.48	$215.10	$336.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $41.45 / $72.01	Professional		$24.69	$41.45	$72.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $13.48 / $33.83	Professional	26	$8.08	$13.48	$33.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $25.77 / $47.63	Professional	TC	$16.60	$25.77	$47.63
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 $28.47 / $46.03 / $54.15	Professional		$28.47	$46.03	$54.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $14.57 / $17.14	Professional	26	$10.07	$14.57	$17.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $31.46 / $37.01	Professional	TC	$18.39	$31.46	$37.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.87 / $75.87 / $110.73	Professional		$75.87	$75.87	$110.73
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.34 / $46.34 / $58.44	Professional	26	$46.34	$46.34	$58.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.53 / $29.53 / $52.29	Professional	TC	$29.53	$29.53	$52.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.21 / $60.52 / $155.25	Facility		$28.21	$60.52	$155.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.03 / $57.64 / $70.08	Professional		$48.03	$57.64	$70.08
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 $34.15 / $39.33 / $41.40	Professional	TC	$34.15	$39.33	$41.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $32.34 / $41.35	Professional		$14.05	$32.34	$41.35
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.19 / $211.17 / $311.69	Facility		$134.19	$211.17	$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 $52.98 / $62.33 / $70.08	Professional		$52.98	$62.33	$70.08
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 $37.85 / $44.53 / $48.82	Professional	TC	$37.85	$44.53	$48.82
United Facility/Professional Professional Modifier Low / Median / High Price $26.21 / $31.16 / $55.26	Professional		$26.21	$31.16	$55.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $9.88 / $21.11	Professional	26	$8.85	$9.88	$21.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.36 / $21.26 / $36.59	Professional	TC	$17.36	$21.26	$36.59