Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.44 / $116.60 / $1,897.34	Facility		$83.44	$116.60	$1,897.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.85 / $26.85 / $26.85	Facility	26	$26.85	$26.85	$26.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $56.59 / $225.52 / $272.95	Facility	TC	$56.59	$225.52	$272.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $73.02 / $167.03	Professional		$35.79	$73.02	$167.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.59 / $71.59 / $71.59	Professional	25	$71.59	$71.59	$71.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $26.85 / $85.42	Professional	26	$20.23	$26.85	$85.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.42 / $234.74 / $234.74	Professional	50	$85.42	$234.74	$234.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.73 / $28.78 / $120.52	Professional	52	$14.73	$28.78	$120.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.27 / $55.64 / $115.00	Professional	TC	$15.27	$55.64	$115.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $83.44 / $126.15	Professional		$42.98	$83.44	$126.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $30.98 / $44.51	Professional	26	$24.09	$30.98	$44.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $54.01 / $83.42	Professional	TC	$19.88	$54.01	$83.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.48 / $29.37 / $43.75	Professional		$22.48	$29.37	$43.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $186.54 / $242.20 / $352.96	Facility		$186.54	$242.20	$352.96
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $203.75 / $203.75 / $203.75	Facility	26	$203.75	$203.75	$203.75
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $203.75 / $203.75 / $203.75	Facility	TC	$203.75	$203.75	$203.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $42.46 / $51.31 / $111.58	Professional		$42.46	$51.31	$111.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $28.71 / $36.68	Professional	26	$23.34	$28.71	$36.68
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $19.13 / $22.59 / $76.01	Professional	TC	$19.13	$22.59	$76.01
United Facility/Professional Professional Modifier Low / Median / High Price $43.18 / $64.76 / $108.00	Professional		$43.18	$64.76	$108.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $24.64 / $38.43	Professional	26	$19.80	$24.64	$38.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.44 / $39.17 / $74.97	Professional	TC	$21.44	$39.17	$74.97