Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.64 / $28.66 / $33.10	Facility	26	$16.64	$28.66	$33.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $62.85 / $320.00 / $343.20	Facility	TC	$62.85	$320.00	$343.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $44.15 / $87.16	Professional		$35.22	$44.15	$87.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $14.48 / $27.30	Professional	26	$12.06	$14.48	$27.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $29.95 / $59.86	Professional	TC	$23.17	$29.95	$59.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.72 / $66.45 / $78.18	Professional		$40.72	$66.45	$78.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.12 / $21.46 / $25.25	Professional	26	$15.12	$21.46	$25.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.60 / $43.88 / $52.51	Professional	TC	$25.60	$43.88	$52.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $159.34 / $159.34 / $176.89	Professional		$159.34	$159.34	$176.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.21 / $49.21 / $81.04	Professional	26	$49.21	$49.21	$81.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.30 / $78.30 / $78.30	Professional	TC	$78.30	$78.30	$78.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.31 / $78.66 / $91.91	Professional		$68.31	$78.66	$91.91
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.28 / $23.35 / $24.58	Professional	26	$20.28	$23.35	$24.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.03 / $55.31 / $58.22	Professional	TC	$48.03	$55.31	$58.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.69 / $32.34 / $66.69	Professional		$20.69	$32.34	$66.69
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 $75.11 / $88.37 / $100.89	Professional		$75.11	$88.37	$100.89
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.13 / $26.03 / $31.31	Professional	26	$22.13	$26.03	$31.31
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $52.99 / $62.34 / $69.58	Professional	TC	$52.99	$62.34	$69.58
United Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $44.45 / $78.94	Professional		$37.44	$44.45	$78.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.27 / $16.26 / $25.83	Professional	26	$13.27	$16.26	$25.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.17 / $29.60 / $51.69	Professional	TC	$24.17	$29.60	$51.69