Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $87.50 / $88.23	Facility	26	$50.00	$87.50	$88.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.92 / $115.47 / $210.14	Professional		$89.92	$115.47	$210.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $36.20 / $73.53	Professional	26	$31.12	$36.20	$73.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.34 / $199.10 / $749.61	Professional	50	$63.34	$199.10	$749.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.88 / $71.63 / $136.61	Professional	TC	$60.88	$71.63	$136.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.35 / $156.49 / $195.61	Professional		$103.35	$156.49	$195.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.03 / $54.20 / $69.41	Professional	26	$37.03	$54.20	$69.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.68 / $102.07 / $128.37	Professional	TC	$66.68	$102.07	$128.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $290.67 / $290.67 / $581.34	Professional		$290.67	$290.67	$581.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $111.03 / $111.03 / $111.03	Professional	26	$111.03	$111.03	$111.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $179.64 / $179.64 / $179.64	Professional	TC	$179.64	$179.64	$179.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $163.32 / $178.16 / $219.74	Professional		$163.32	$178.16	$219.74
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.51 / $58.87 / $67.28	Professional	26	$55.51	$58.87	$67.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.81 / $114.35 / $130.68	Professional	TC	$107.81	$114.35	$130.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $62.67 / $178.07	Professional		$32.34	$62.67	$178.07
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 $179.33 / $210.98 / $243.89	Professional		$179.33	$210.98	$243.89
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $59.98 / $70.56 / $85.12	Professional	26	$59.98	$70.56	$85.12
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $119.36 / $140.41 / $158.77	Professional	TC	$119.36	$140.41	$158.77
United Facility/Professional Professional Modifier Low / Median / High Price $104.16 / $114.76 / $205.36	Professional		$104.16	$114.76	$205.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.74 / $39.14 / $70.04	Professional	26	$35.74	$39.14	$70.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.42 / $75.62 / $135.32	Professional	TC	$68.42	$75.62	$135.32