Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.84 / $141.60 / $141.60	Facility	26	$76.84	$141.60	$141.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.16 / $321.13 / $363.62	Professional		$197.16	$321.13	$363.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.06 / $72.68 / $157.34	Professional	26	$56.06	$72.68	$157.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.11 / $231.15 / $287.80	Professional	TC	$137.11	$231.15	$287.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.41 / $143.52 / $406.26	Professional		$128.41	$143.52	$406.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.54 / $49.78 / $101.21	Professional	26	$44.54	$49.78	$101.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.88 / $93.75 / $277.64	Professional	TC	$83.88	$93.75	$277.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $850.75 / $850.75 / $944.41	Professional		$850.75	$850.75	$944.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $266.70 / $266.70 / $425.34	Professional	26	$266.70	$266.70	$425.34
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $425.41 / $425.41 / $677.70	Professional	TC	$425.41	$425.41	$677.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $247.10 / $284.54 / $370.58	Professional		$247.10	$284.54	$370.58
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 $162.24 / $186.83 / $218.29	Professional	TC	$162.24	$186.83	$218.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $96.21 / $242.10	Professional		$32.34	$96.21	$242.10
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 $272.49 / $320.58 / $370.58	Professional		$272.49	$320.58	$370.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $92.00 / $108.23 / $131.08	Professional	26	$92.00	$108.23	$131.08
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $180.50 / $212.35 / $239.50	Professional	TC	$180.50	$212.35	$239.50
United Facility/Professional Professional Modifier Low / Median / High Price $144.18 / $256.62 / $514.45	Professional		$144.18	$256.62	$514.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.08 / $69.29 / $132.02	Professional	26	$49.08	$69.29	$132.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.10 / $190.19 / $357.50	Professional	TC	$95.10	$190.19	$357.50