Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.27 / $14.27 / $14.27	Facility	26	$14.27	$14.27	$14.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.64 / $108.70 / $421.00	Professional		$58.64	$108.70	$421.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $14.27 / $57.00	Professional	26	$11.06	$14.27	$57.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.86 / $62.37 / $229.70	Professional	52	$37.86	$62.37	$229.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.70 / $110.45 / $164.47	Professional	TC	$64.70	$110.45	$164.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.26 / $124.21 / $169.83	Professional		$95.26	$124.21	$169.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $16.80 / $25.64	Professional	26	$13.88	$16.80	$25.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.20 / $107.84 / $144.75	Professional	TC	$80.20	$107.84	$144.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $58.74 / $77.63	Professional		$45.85	$58.74	$77.63
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 Professional Modifier Low / Median / High Price $94.48 / $122.88 / $155.31	Professional		$94.48	$122.88	$155.31
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $17.41 / $22.85	Professional	26	$13.39	$17.41	$22.85
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $81.09 / $105.47 / $132.46	Professional	TC	$81.09	$105.47	$132.46
United Facility/Professional Professional Modifier Low / Median / High Price $79.20 / $113.56 / $210.42	Professional		$79.20	$113.56	$210.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $13.98 / $21.36	Professional	26	$11.52	$13.98	$21.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.28 / $95.47 / $144.50	Professional	TC	$65.28	$95.47	$144.50