Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.00 / $399.46 / $464.70	Facility	26	$128.00	$399.46	$464.70
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $95.00 / $95.00 / $95.00	Facility	53	$95.00	$95.00	$95.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.09 / $475.00 / $1,415.33	Professional		$206.09	$475.00	$1,415.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.61 / $117.69 / $305.89	Professional	26	$60.61	$117.69	$305.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $101.07 / $207.13 / $319.00	Professional	52	$101.07	$207.13	$319.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.84 / $335.00 / $472.35	Professional	TC	$176.84	$335.00	$472.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.19 / $395.11 / $741.47	Professional		$191.19	$395.11	$741.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.48 / $86.90 / $152.35	Professional	26	$62.48	$86.90	$152.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.30 / $260.89 / $644.42	Professional	TC	$123.30	$260.89	$644.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.98 / $114.79 / $167.13	Professional		$52.98	$114.79	$167.13
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $418.84 / $418.84 / $418.84	Facility	26	$418.84	$418.84	$418.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $299.91 / $349.99 / $477.67	Professional		$299.91	$349.99	$477.67
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $103.11 / $120.33 / $157.72	Professional	26	$103.11	$120.33	$157.72
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $196.80 / $229.66 / $325.52	Professional	TC	$196.80	$229.66	$325.52
United Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $339.96 / $637.50	Professional		$192.64	$339.96	$637.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.67 / $64.88 / $126.61	Professional	26	$62.67	$64.88	$126.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $225.73 / $423.88	Professional	TC	$127.91	$225.73	$423.88