Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.10 / $19.57 / $19.75	Facility	26	$18.10	$19.57	$19.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.91 / $115.57 / $148.63	Professional		$85.91	$115.57	$148.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.59 / $12.92 / $20.63	Professional	26	$10.59	$12.92	$20.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.93 / $54.10 / $292.64	Professional	52	$37.93	$54.10	$292.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.58 / $104.06 / $130.94	Professional	TC	$77.58	$104.06	$130.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.13 / $130.51 / $177.22	Professional		$92.13	$130.51	$177.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.90 / $18.22 / $23.88	Professional	26	$12.90	$18.22	$23.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.02 / $110.53 / $136.63	Professional	TC	$78.02	$110.53	$136.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.58 / $134.58 / $134.58	Professional		$134.58	$134.58	$134.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.13 / $39.13 / $47.25	Professional	26	$39.13	$39.13	$47.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.33 / $87.33 / $95.45	Professional	TC	$87.33	$87.33	$95.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $118.88 / $138.69 / $158.50	Professional		$118.88	$138.69	$158.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.68 / $19.80 / $22.64	Professional	26	$18.68	$19.80	$22.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.08 / $122.27 / $142.65	Professional	TC	$112.08	$122.27	$142.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.53 / $32.34 / $140.36	Professional		$18.53	$32.34	$140.36
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 $113.19 / $122.88 / $130.57	Professional		$113.19	$122.88	$130.57
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $17.41 / $19.62	Professional	26	$16.48	$17.41	$19.62
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $96.56 / $105.47 / $110.95	Professional	TC	$96.56	$105.47	$110.95
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $137.71 / $183.61	Professional		$91.20	$137.71	$183.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.99 / $17.28 / $22.99	Professional	26	$12.99	$17.28	$22.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.52 / $121.95 / $170.73	Professional	TC	$77.52	$121.95	$170.73