Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.20 / $161.50 / $162.86	Facility	26	$87.20	$161.50	$162.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.54 / $268.99 / $351.50	Professional		$203.54	$268.99	$351.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $85.03 / $167.42	Professional	26	$55.15	$85.03	$167.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.41 / $201.03 / $231.46	Professional	TC	$135.41	$201.03	$231.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.38 / $149.08 / $422.56	Professional		$133.38	$149.08	$422.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.55 / $56.49 / $115.04	Professional	26	$50.55	$56.49	$115.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.84 / $92.58 / $315.43	Professional	TC	$82.84	$92.58	$315.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $615.16 / $615.16 / $737.31	Professional		$615.16	$615.16	$737.31
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $483.94 / $483.94 / $486.06	Professional	26	$483.94	$483.94	$486.06
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.22 / $131.22 / $251.25	Professional	TC	$131.22	$131.22	$251.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $258.32 / $297.45 / $386.95	Professional		$258.32	$297.45	$386.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.61 / $111.25 / $129.97	Professional	26	$96.61	$111.25	$129.97
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $161.72 / $186.22 / $217.58	Professional	TC	$161.72	$186.22	$217.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $86.96 / $282.38	Professional		$32.34	$86.96	$282.38
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 $284.72 / $334.97 / $386.95	Professional		$284.72	$334.97	$386.95
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $105.39 / $123.99 / $148.99	Professional	26	$105.39	$123.99	$148.99
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $179.33 / $210.98 / $237.96	Professional	TC	$179.33	$210.98	$237.96
United Facility/Professional Professional Modifier Low / Median / High Price $173.02 / $257.49 / $485.65	Professional		$173.02	$257.49	$485.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.24 / $68.78 / $123.08	Professional	26	$53.24	$68.78	$123.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.50 / $204.25 / $438.02	Professional	TC	$117.50	$204.25	$438.02