Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $339.00 / $602.27	Facility		$100.09	$339.00	$602.27
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.86 / $151.13 / $162.47	Facility	26	$30.86	$151.13	$162.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $170.41 / $496.66	Professional		$107.34	$170.41	$496.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $43.20 / $142.00	Professional	26	$22.69	$43.20	$142.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $47.34 / $64.05 / $337.21	Professional	52	$47.34	$64.05	$337.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.68 / $103.70 / $501.61	Professional	TC	$79.68	$103.70	$501.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.63 / $191.49 / $432.14	Facility		$111.63	$191.49	$432.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.88 / $152.76 / $233.48	Professional		$110.88	$152.76	$233.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.55 / $38.19 / $57.85	Professional	26	$28.55	$38.19	$57.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.01 / $115.84 / $174.91	Professional	TC	$81.01	$115.84	$174.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $65.14 / $133.01	Professional		$32.34	$65.14	$133.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $169.70 / $225.21 / $387.37	Facility		$169.70	$225.21	$387.37
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $198.33 / $198.33 / $198.33	Facility	26	$198.33	$198.33	$198.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $164.08 / $209.28 / $240.23	Professional		$164.08	$209.28	$240.23
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $39.15 / $50.30 / $59.23	Professional	26	$39.15	$50.30	$59.23
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $124.92 / $158.59 / $181.58	Professional	TC	$124.92	$158.59	$181.58
United Facility/Professional Professional Modifier Low / Median / High Price $109.64 / $118.01 / $191.52	Professional		$109.64	$118.01	$191.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.77 / $28.87 / $48.51	Professional	26	$27.77	$28.87	$48.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.87 / $91.06 / $143.79	Professional	TC	$81.87	$91.06	$143.79