Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $8.69 / $28.31	Facility		$8.69	$8.69	$28.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.68 / $19.68 / $19.68	Facility	26	$19.68	$19.68	$19.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.83 / $13.12 / $23.10	Professional		$10.83	$13.12	$23.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.31 / $8.83 / $16.17	Professional	26	$7.31	$8.83	$16.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $12.27 / $12.27 / $12.27	Professional	50	$12.27	$12.27	$12.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.08 / $4.44 / $6.93	Professional	TC	$3.08	$4.44	$6.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.78 / $83.26 / $163.38	Facility		$33.78	$83.26	$163.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.63 / $18.16 / $27.22	Professional		$12.63	$18.16	$27.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.67 / $12.48 / $17.03	Professional	26	$8.67	$12.48	$17.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.77 / $5.45 / $9.51	Professional	TC	$3.77	$5.45	$9.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.18 / $34.18 / $50.23	Professional		$34.18	$34.18	$50.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $22.87 / $49.05	Professional	26	$22.87	$22.87	$49.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.18 / $1.18 / $11.31	Professional	TC	$1.18	$1.18	$11.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $10.81 / $23.10 / $31.09	Facility		$10.81	$23.10	$31.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $18.14 / $19.25 / $26.65	Professional		$18.14	$19.25	$26.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $14.14 / $18.14	Professional	26	$12.28	$14.14	$18.14
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.87 / $6.23 / $7.12	Professional	TC	$5.87	$6.23	$7.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.41 / $13.71 / $32.34	Professional		$5.41	$13.71	$32.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $70.93 / $104.40	Facility		$47.86	$70.93	$104.40
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	26	$47.86	$47.86	$47.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $23.29 / $26.65	Professional		$19.80	$23.29	$26.65
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $15.76 / $18.57	Professional	26	$13.40	$15.76	$18.57
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $6.41 / $7.54 / $8.07	Professional	TC	$6.41	$7.54	$8.07
United Facility/Professional Professional Modifier Low / Median / High Price $12.27 / $14.64 / $27.10	Professional		$12.27	$14.64	$27.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $9.52 / $17.64	Professional	26	$8.30	$9.52	$17.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.97 / $5.11 / $9.46	Professional	TC	$3.97	$5.11	$9.46