Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.70 / $72.68 / $76.34	Facility	26	$41.70	$72.68	$76.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.14 / $58.53 / $107.39	Professional		$50.14	$58.53	$107.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.57 / $32.58 / $64.84	Professional	26	$26.57	$32.58	$64.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.40 / $49.30 / $84.29	Professional	52	$33.40	$49.30	$84.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $27.86 / $46.90	Professional	TC	$23.57	$27.86	$46.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.90 / $86.00 / $101.18	Professional		$58.90	$86.00	$101.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.94 / $48.02 / $56.50	Professional	26	$32.94	$48.02	$56.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.96 / $37.97 / $44.68	Professional	TC	$25.96	$37.97	$44.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.60 / $110.60 / $203.11	Professional		$110.60	$110.60	$203.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $111.21 / $111.21 / $126.11	Professional	26	$111.21	$111.21	$126.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.00 / $77.00 / $111.21	Professional	TC	$77.00	$77.00	$111.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.79 / $96.48 / $125.45	Professional		$83.79	$96.48	$125.45
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $52.23 / $54.98	Professional	26	$45.36	$52.23	$54.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.43 / $40.76 / $46.58	Professional	TC	$38.43	$40.76	$46.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $41.24 / $92.55	Professional		$32.34	$41.24	$92.55
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $49.41 / $49.41 / $49.41	Facility	26	$49.41	$49.41	$49.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $90.83 / $106.86 / $125.45	Professional		$90.83	$106.86	$125.45
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $48.91 / $57.54 / $70.09	Professional	26	$48.91	$57.54	$70.09
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $41.92 / $49.32 / $55.36	Professional	TC	$41.92	$49.32	$55.36
United Facility/Professional Professional Modifier Low / Median / High Price $58.78 / $72.00 / $106.76	Professional		$58.78	$72.00	$106.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.82 / $33.75 / $57.81	Professional	26	$31.82	$33.75	$57.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $27.78 / $47.59	Professional	TC	$26.60	$27.78	$47.59