Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.95 / $136.06 / $142.91	Facility	26	$73.95	$136.06	$142.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.91 / $247.94 / $335.13	Professional		$162.91	$247.94	$335.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.76 / $73.80 / $130.34	Professional	26	$45.76	$73.80	$130.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $81.52 / $140.38 / $146.99	Professional	52	$81.52	$140.38	$146.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.89 / $179.64 / $257.52	Professional	TC	$112.89	$179.64	$257.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.85 / $125.00 / $336.62	Professional		$111.85	$125.00	$336.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.79 / $47.83 / $104.72	Professional	26	$42.79	$47.83	$104.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.05 / $77.18 / $245.71	Professional	TC	$69.05	$77.18	$245.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $722.46 / $722.46 / $982.37	Professional		$722.46	$722.46	$982.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $440.87 / $440.87 / $441.78	Professional	26	$440.87	$440.87	$441.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $280.68 / $280.68 / $541.50	Professional	TC	$280.68	$280.68	$541.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $216.15 / $248.90 / $324.76	Professional		$216.15	$248.90	$324.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.13 / $93.42 / $109.16	Professional	26	$81.13	$93.42	$109.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $135.04 / $155.50 / $181.68	Professional	TC	$135.04	$155.50	$181.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $82.48 / $236.54	Professional		$32.34	$82.48	$236.54
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 $238.14 / $280.16 / $324.76	Professional		$238.14	$280.16	$324.76
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $88.50 / $104.12 / $125.24	Professional	26	$88.50	$104.12	$125.24
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $149.63 / $176.05 / $199.52	Professional	TC	$149.63	$176.05	$199.52
United Facility/Professional Professional Modifier Low / Median / High Price $136.51 / $200.50 / $401.94	Professional		$136.51	$200.50	$401.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.54 / $62.32 / $111.53	Professional	26	$42.54	$62.32	$111.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $157.96 / $316.67	Professional	TC	$86.20	$157.96	$316.67