Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.15 / $138.15 / $143.62	Facility	26	$138.15	$138.15	$143.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.63 / $275.00 / $328.53	Professional		$191.63	$275.00	$328.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.57 / $59.10 / $119.69	Professional	26	$48.57	$59.10	$119.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.16 / $208.83 / $238.06	Professional	TC	$131.16	$208.83	$238.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.03 / $139.74 / $313.58	Professional		$125.03	$139.74	$313.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.80 / $50.07 / $102.14	Professional	26	$44.80	$50.07	$102.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.23 / $89.68 / $226.26	Professional	TC	$80.23	$89.68	$226.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $700.85 / $700.85 / $778.01	Professional		$700.85	$700.85	$778.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $388.17 / $388.17 / $431.50	Professional	26	$388.17	$388.17	$431.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $312.68 / $312.68 / $346.51	Professional	TC	$312.68	$312.68	$346.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $241.25 / $277.80 / $360.59	Professional		$241.25	$277.80	$360.59
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.86 / $97.72 / $114.17	Professional	26	$84.86	$97.72	$114.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $156.38 / $180.08 / $210.41	Professional	TC	$156.38	$180.08	$210.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $86.35 / $236.44	Professional		$32.34	$86.35	$236.44
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $346.39	Facility	26	$346.39	$346.39	$346.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $265.51 / $312.36 / $360.59	Professional		$265.51	$312.36	$360.59
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $92.58 / $108.92 / $131.08	Professional	26	$92.58	$108.92	$131.08
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $172.93 / $203.45 / $229.50	Professional	TC	$172.93	$203.45	$229.50
United Facility/Professional Professional Modifier Low / Median / High Price $140.80 / $204.84 / $446.02	Professional		$140.80	$204.84	$446.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.58 / $60.80 / $112.70	Professional	26	$46.58	$60.80	$112.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.72 / $158.26 / $317.27	Professional	TC	$91.72	$158.26	$317.27