Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.25 / $29.75 / $29.75	Facility	26	$26.25	$29.75	$29.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.45 / $78.26 / $227.00	Professional		$54.45	$78.26	$227.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $25.00 / $79.00	Professional	26	$16.32	$25.00	$79.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.68 / $47.72 / $65.45	Professional	TC	$37.68	$47.72	$65.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.86 / $83.38 / $100.55	Professional		$58.86	$83.38	$100.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.52 / $27.81 / $35.63	Professional	26	$19.52	$27.81	$35.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.00 / $53.83 / $69.14	Professional	TC	$38.00	$53.83	$69.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $364.61 / $364.61 / $1,743.01	Professional		$364.61	$364.61	$1,743.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.53 / $57.53 / $68.37	Professional	26	$57.53	$57.53	$68.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $296.24 / $296.24 / $1,685.48	Professional	TC	$296.24	$296.24	$1,685.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.06 / $84.91 / $97.04	Professional		$80.06	$84.91	$97.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.75 / $29.44 / $33.64	Professional	26	$27.75	$29.44	$33.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.31 / $55.48 / $63.40	Professional	TC	$52.31	$55.48	$63.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $32.34 / $87.56	Professional		$28.46	$32.34	$87.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.43 / $75.62 / $100.64	Professional		$74.43	$75.62	$100.64
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $25.30 / $25.87 / $33.04	Professional	26	$25.30	$25.87	$33.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $49.14 / $49.75 / $65.98	Professional	TC	$49.14	$49.75	$65.98
United Facility/Professional Professional Modifier Low / Median / High Price $57.38 / $80.45 / $108.49	Professional		$57.38	$80.45	$108.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.71 / $27.05 / $34.99	Professional	26	$19.71	$27.05	$34.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.44 / $51.68 / $75.26	Professional	TC	$37.44	$51.68	$75.26