Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.10 / $28.10 / $28.34	Facility	26	$16.10	$28.10	$28.34
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $50.60 / $177.65 / $380.00	Facility	TC	$50.60	$177.65	$380.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $44.30 / $86.70	Professional		$30.19	$44.30	$86.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.31 / $17.17 / $29.86	Professional	26	$10.31	$17.17	$29.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $31.69 / $55.66	Professional	TC	$19.89	$31.69	$55.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $57.32 / $66.50	Professional		$34.77	$57.32	$66.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.77 / $18.46 / $21.85	Professional	26	$12.77	$18.46	$21.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.00 / $38.51 / $45.01	Professional	TC	$22.00	$38.51	$45.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.38 / $89.38 / $136.38	Professional		$89.38	$89.38	$136.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.97 / $73.97 / $73.97	Professional	26	$73.97	$73.97	$73.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.42 / $62.42 / $62.42	Professional	TC	$62.42	$62.42	$62.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $59.24 / $68.20 / $79.70	Professional		$59.24	$68.20	$79.70
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.61 / $20.27 / $21.34	Professional	26	$17.61	$20.27	$21.34
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.63 / $47.94 / $50.46	Professional	TC	$41.63	$47.94	$50.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $32.34 / $64.34	Professional		$17.89	$32.34	$64.34
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	TC	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $75.34 / $86.68	Professional		$64.05	$75.34	$86.68
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.63 / $21.92 / $27.10	Professional	26	$18.63	$21.92	$27.10
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $45.42 / $53.43 / $59.58	Professional	TC	$45.42	$53.43	$59.58
United Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $38.27 / $67.45	Professional		$32.00	$38.27	$67.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $12.54 / $22.44	Professional	26	$11.23	$12.54	$22.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.77 / $25.76 / $46.24	Professional	TC	$20.77	$25.76	$46.24