Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.14 / $41.14 / $1,251.00	Facility		$41.14	$41.14	$1,251.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.58 / $5.58 / $5.58	Facility	26	$5.58	$5.58	$5.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.02 / $30.46 / $48.87	Professional		$26.02	$30.46	$48.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.75 / $4.23 / $4.74	Professional	26	$3.75	$4.23	$4.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.00 / $16.41 / $17.14	Professional	52	$11.00	$16.41	$17.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $27.61 / $34.51	Professional	TC	$25.10	$27.61	$34.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $35.64 / $48.92	Professional		$24.70	$35.64	$48.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.71 / $4.76 / $7.98	Professional	26	$3.71	$4.76	$7.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.99 / $30.36 / $35.18	Professional	TC	$20.99	$30.36	$35.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.78 / $66.78 / $80.31	Professional		$66.78	$66.78	$80.31
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $11.32 / $15.03	Professional	26	$11.32	$11.32	$15.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.75 / $51.75 / $69.00	Professional	TC	$51.75	$51.75	$69.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $22.42 / $39.43 / $64.23	Facility		$22.42	$39.43	$64.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.83 / $39.06 / $54.35	Professional		$36.83	$39.06	$54.35
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.80 / $5.53 / $6.46	Professional	26	$4.80	$5.53	$6.46
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.03 / $36.88 / $44.64	Professional	TC	$32.03	$36.88	$44.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.63 / $32.34 / $35.22	Professional		$4.63	$32.34	$35.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $75.94 / $122.20 / $162.90	Facility		$75.94	$122.20	$162.90
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $107.98 / $107.98 / $107.98	Facility	26	$107.98	$107.98	$107.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $29.75 / $31.36 / $36.40	Professional		$29.75	$31.36	$36.40
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $3.83 / $4.03 / $4.83	Professional	26	$3.83	$4.03	$4.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $25.84 / $27.33 / $31.58	Professional	TC	$25.84	$27.33	$31.58
United Facility/Professional Professional Modifier Low / Median / High Price $22.38 / $32.25 / $52.90	Professional		$22.38	$32.25	$52.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.25 / $4.72 / $6.95	Professional	26	$3.25	$4.72	$6.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.13 / $27.44 / $38.74	Professional	TC	$19.13	$27.44	$38.74