Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.17 / $477.90 / $670.50	Facility		$203.17	$477.90	$670.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.67 / $70.98 / $89.48	Facility	26	$40.67	$70.98	$89.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $111.33 / $258.39 / $643.35	Facility	TC	$111.33	$258.39	$643.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.89 / $121.14 / $539.25	Professional		$87.89	$121.14	$539.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $43.00 / $144.88	Professional	26	$25.26	$43.00	$144.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.32 / $81.29 / $143.54	Professional	TC	$54.32	$81.29	$143.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.86 / $367.78 / $603.27	Facility		$148.86	$367.78	$603.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.67 / $137.22 / $189.78	Professional		$87.67	$137.22	$189.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.55 / $43.12 / $56.57	Professional	26	$29.55	$43.12	$56.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.04 / $94.12 / $137.75	Professional	TC	$58.04	$94.12	$137.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $258.37 / $258.37 / $261.97	Professional		$258.37	$258.37	$261.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.24 / $112.24 / $132.26	Professional	26	$112.24	$112.24	$132.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.71 / $129.71 / $146.13	Professional	TC	$129.71	$129.71	$146.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.13 / $178.40 / $305.20	Facility		$81.13	$178.40	$305.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.77 / $155.59 / $188.02	Professional		$138.77	$155.59	$188.02
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.30 / $48.33 / $53.70	Professional	26	$44.30	$48.33	$53.70
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $94.46 / $103.05 / $114.50	Professional	TC	$94.46	$103.05	$114.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $50.12 / $151.19	Professional		$32.34	$50.12	$151.19
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $211.40 / $288.06 / $458.49	Facility		$211.40	$288.06	$458.49
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 Facility Modifier TC Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	TC	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.97 / $178.79 / $207.23	Professional		$151.97	$178.79	$207.23
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.74 / $56.17 / $68.45	Professional	26	$47.74	$56.17	$68.45
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $104.23 / $122.62 / $138.78	Professional	TC	$104.23	$122.62	$138.78
United Facility/Professional Professional Modifier Low / Median / High Price $92.75 / $109.94 / $203.49	Professional		$92.75	$109.94	$203.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.59 / $33.77 / $60.48	Professional	26	$28.59	$33.77	$60.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.80 / $81.34 / $150.57	Professional	TC	$62.80	$81.34	$150.57