Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.50 / $161.50 / $161.50	Facility	26	$142.50	$161.50	$161.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.49 / $259.58 / $333.43	Professional		$192.49	$259.58	$333.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $68.13 / $147.12	Professional	26	$55.15	$68.13	$147.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.36 / $197.71 / $225.38	Professional	TC	$124.36	$197.71	$225.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.62 / $141.52 / $345.98	Professional		$126.62	$141.52	$345.98
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 $76.08 / $85.03 / $248.32	Professional	TC	$76.08	$85.03	$248.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $680.60 / $680.60 / $755.53	Professional		$680.60	$680.60	$755.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $252.22 / $252.22 / $483.94	Professional	26	$252.22	$252.22	$483.94
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.66 / $196.66 / $503.31	Professional	TC	$196.66	$196.66	$503.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $243.90 / $280.86 / $366.96	Professional		$243.90	$280.86	$366.96
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 $147.31 / $169.63 / $198.20	Professional	TC	$147.31	$169.63	$198.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $98.18 / $239.79	Professional		$32.34	$98.18	$239.79
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 $268.42 / $315.79 / $366.96	Professional		$268.42	$315.79	$366.96
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $104.81 / $123.30 / $148.99	Professional	26	$104.81	$123.30	$148.99
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $163.62 / $192.49 / $217.97	Professional	TC	$163.62	$192.49	$217.97
United Facility/Professional Professional Modifier Low / Median / High Price $142.03 / $208.02 / $417.02	Professional		$142.03	$208.02	$417.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.24 / $69.16 / $131.36	Professional	26	$53.24	$69.16	$131.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $154.78 / $326.58	Professional	TC	$86.20	$154.78	$326.58