Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.59 / $69.42 / $72.92	Facility	26	$39.59	$69.42	$72.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.02 / $87.92 / $135.50	Professional		$61.02	$87.92	$135.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $29.04 / $76.89	Professional	26	$23.46	$29.04	$76.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.56 / $39.68 / $59.43	Professional	52	$21.56	$39.68	$59.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.64 / $55.88 / $69.59	Professional	TC	$27.64	$55.88	$69.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.05 / $104.90 / $166.80	Professional		$74.05	$104.90	$166.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.58 / $42.06 / $54.52	Professional	26	$27.58	$42.06	$54.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.67 / $59.03 / $107.50	Professional	TC	$41.67	$59.03	$107.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $257.92 / $257.92 / $286.32	Professional		$257.92	$257.92	$286.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.88 / $145.88 / $145.88	Professional	26	$145.88	$145.88	$145.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.03 / $112.03 / $140.43	Professional	TC	$112.03	$112.03	$140.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $92.86 / $104.12 / $134.71	Professional		$92.86	$104.12	$134.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.23 / $47.16 / $52.40	Professional	26	$43.23	$47.16	$52.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.63 / $52.64 / $60.16	Professional	TC	$49.63	$52.64	$60.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.83 / $101.95	Professional		$32.34	$46.83	$101.95
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 $99.57 / $117.14 / $134.19	Professional		$99.57	$117.14	$134.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $46.58 / $54.80 / $66.92	Professional	26	$46.58	$54.80	$66.92
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $52.99 / $62.34 / $67.27	Professional	TC	$52.99	$62.34	$67.27
United Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $89.52 / $165.69	Professional		$80.48	$89.52	$165.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.55 / $29.59 / $53.29	Professional	26	$26.55	$29.59	$53.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.89 / $62.97 / $119.51	Professional	TC	$50.89	$62.97	$119.51