Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $314.50 / $314.50 / $314.50	Facility		$314.50	$314.50	$314.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.60 / $115.00 / $276.79	Professional		$41.60	$115.00	$276.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.21 / $79.95 / $112.80	Professional	26	$38.21	$79.95	$112.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.86 / $59.59 / $168.38	Professional	TC	$29.86	$59.59	$168.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.73 / $110.08 / $150.03	Professional		$91.73	$110.08	$150.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.95 / $63.55 / $83.16	Professional	26	$52.95	$63.55	$83.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.78 / $46.53 / $66.86	Professional	TC	$38.78	$46.53	$66.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.86 / $159.49 / $407.48	Facility		$74.86	$159.49	$407.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.48 / $111.80 / $137.88	Professional		$102.48	$111.80	$137.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $61.71 / $111.80	Professional	26	$58.18	$61.71	$111.80
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.30 / $46.99 / $69.81	Professional	TC	$44.30	$46.99	$69.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $47.25 / $112.34	Professional		$32.34	$47.25	$112.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $270.73 / $386.99 / $485.01	Facility		$270.73	$386.99	$485.01
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $270.73 / $270.73 / $270.73	Facility	26	$270.73	$270.73	$270.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.91 / $98.72 / $120.16	Professional		$83.91	$98.72	$120.16
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.39 / $55.75 / $70.18	Professional	26	$47.39	$55.75	$70.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $36.52 / $42.97 / $49.98	Professional	TC	$36.52	$42.97	$49.98
United Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $8,244.00 / $9,193.00	Facility		$1,800.00	$8,244.00	$9,193.00
United Facility/Professional Professional Modifier Low / Median / High Price $72.95 / $213.12 / $370.19	Professional		$72.95	$213.12	$370.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.80 / $81.73 / $156.77	Professional	26	$41.80	$81.73	$156.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.16 / $115.53 / $221.95	Professional	TC	$31.16	$115.53	$221.95