Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $80.08 / $149.00	Professional		$42.76	$80.08	$149.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.09 / $31.94 / $54.91	Professional	26	$27.09	$31.94	$54.91
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $209.18 / $209.18 / $209.18	Professional	50	$209.18	$209.18	$209.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.55 / $37.79 / $45.26	Professional	52	$19.55	$37.79	$45.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $52.74 / $71.00	Professional	TC	$16.26	$52.74	$71.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.78 / $91.17 / $143.55	Professional		$60.78	$91.17	$143.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.65 / $45.08 / $59.63	Professional	26	$31.65	$45.08	$59.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.88 / $39.60 / $77.26	Professional	TC	$25.88	$39.60	$77.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $118.42 / $118.42 / $154.47	Professional		$118.42	$118.42	$154.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $115.85 / $115.85 / $130.22	Professional	26	$115.85	$115.85	$130.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.57 / $2.57 / $24.25	Professional	TC	$2.57	$2.57	$24.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $44.98 / $96.73 / $128.71	Facility		$44.98	$96.73	$128.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.26 / $79.81 / $101.25	Professional		$75.26	$79.81	$101.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.50 / $50.38 / $57.58	Professional	26	$47.50	$50.38	$57.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.75 / $29.44 / $33.64	Professional	TC	$27.75	$29.44	$33.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $32.34 / $83.32	Professional		$25.15	$32.34	$83.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $230.28 / $312.54 / $387.23	Facility		$230.28	$312.54	$387.23
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $217.18 / $217.18 / $217.18	Facility	26	$217.18	$217.18	$217.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.77 / $63.17 / $77.22	Professional		$61.77	$63.17	$77.22
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $38.27 / $39.86 / $50.41	Professional	26	$38.27	$39.86	$50.41
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $22.50 / $23.30 / $26.81	Professional	TC	$22.50	$23.30	$26.81
United Facility/Professional Professional Modifier Low / Median / High Price $66.88 / $114.36 / $148.49	Professional		$66.88	$114.36	$148.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.57 / $40.02 / $55.46	Professional	26	$32.57	$40.02	$55.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.44 / $59.84 / $94.07	Professional	TC	$33.44	$59.84	$94.07