Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.76 / $106.54 / $134.29	Facility	26	$60.76	$106.54	$134.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.99 / $214.93 / $399.63	Professional		$135.99	$214.93	$399.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.46 / $56.17 / $120.73	Professional	26	$36.46	$56.17	$120.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.37 / $144.19 / $263.31	Professional	TC	$90.37	$144.19	$263.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.03 / $99.51 / $264.11	Professional		$89.03	$99.51	$264.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.77 / $37.74 / $76.39	Professional	26	$33.77	$37.74	$76.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.27 / $61.77 / $182.65	Professional	TC	$55.27	$61.77	$182.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $588.94 / $588.94 / $596.87	Professional		$588.94	$588.94	$596.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $257.35 / $257.35 / $258.48	Professional	26	$257.35	$257.35	$258.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $330.46 / $330.46 / $339.52	Professional	TC	$330.46	$330.46	$339.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.46 / $199.75 / $258.83	Professional		$173.46	$199.75	$258.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.05 / $73.76 / $86.18	Professional	26	$64.05	$73.76	$86.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.41 / $125.99 / $147.21	Professional	TC	$109.41	$125.99	$147.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.54 / $170.21	Professional		$32.34	$72.54	$170.21
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $189.81 / $223.31 / $258.83	Professional		$189.81	$223.31	$258.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $69.29 / $81.52 / $98.53	Professional	26	$69.29	$81.52	$98.53
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $120.52 / $141.79 / $160.30	Professional	TC	$120.52	$141.79	$160.30
United Facility/Professional Professional Modifier Low / Median / High Price $99.70 / $156.81 / $314.35	Professional		$99.70	$156.81	$314.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.01 / $45.98 / $82.29	Professional	26	$35.01	$45.98	$82.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.58 / $117.41 / $252.53	Professional	TC	$62.58	$117.41	$252.53