Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.12 / $78.12 / $78.12	Facility	26	$78.12	$78.12	$78.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $77.64 / $135.32	Professional		$59.33	$77.64	$135.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $28.63 / $62.89	Professional	26	$22.04	$28.63	$62.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.36 / $35.01 / $67.66	Professional	52	$21.36	$35.01	$67.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.97 / $49.53 / $72.43	Professional	TC	$30.97	$49.53	$72.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $105.17 / $144.29	Professional		$73.73	$105.17	$144.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.78 / $46.54 / $59.63	Professional	26	$29.78	$46.54	$59.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.47 / $55.91 / $77.47	Professional	TC	$39.47	$55.91	$77.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $164.38 / $164.38 / $193.10	Professional		$164.38	$164.38	$193.10
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.67 / $121.67 / $147.16	Professional	26	$121.67	$121.67	$147.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.71 / $42.71 / $45.94	Professional	TC	$42.71	$42.71	$45.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $108.88 / $122.08 / $146.50	Professional		$108.88	$122.08	$146.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.03 / $50.94 / $58.22	Professional	26	$48.03	$50.94	$58.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.85 / $64.54 / $73.76	Professional	TC	$60.85	$64.54	$73.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $54.41 / $119.40	Professional		$32.34	$54.41	$119.40
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 Professional Modifier Low / Median / High Price $118.78 / $139.74 / $158.74	Professional		$118.78	$139.74	$158.74
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $51.82 / $60.97 / $73.01	Professional	26	$51.82	$60.97	$73.01
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $66.95 / $78.77 / $85.72	Professional	TC	$66.95	$78.77	$85.72
United Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $81.69 / $151.19	Professional		$67.84	$81.69	$151.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.63 / $32.93 / $59.84	Professional	26	$30.63	$32.93	$59.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.09 / $51.06 / $92.02	Professional	TC	$36.09	$51.06	$92.02