Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.91 / $146.09 / $147.32	Facility	26	$79.91	$146.09	$147.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.32 / $316.16 / $373.69	Professional		$201.32	$316.16	$373.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $82.80 / $210.87	Professional	26	$53.67	$82.80	$210.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.96 / $245.67 / $285.08	Professional	TC	$154.96	$245.67	$285.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.01 / $157.60 / $417.51	Professional		$141.01	$157.60	$417.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.21 / $51.64 / $111.80	Professional	26	$46.21	$51.64	$111.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.80 / $105.96 / $312.27	Professional	TC	$94.80	$105.96	$312.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $642.61 / $642.61 / $881.81	Professional		$642.61	$642.61	$881.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $470.55 / $470.55 / $470.55	Professional	26	$470.55	$470.55	$470.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $172.06 / $172.06 / $411.26	Professional	TC	$172.06	$172.06	$411.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $271.13 / $312.20 / $405.83	Professional		$271.13	$312.20	$405.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.53 / $100.80 / $117.77	Professional	26	$87.53	$100.80	$117.77
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $183.60 / $211.41 / $247.02	Professional	TC	$183.60	$211.41	$247.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $99.26 / $265.37	Professional		$32.34	$99.26	$265.37
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 $299.27 / $352.09 / $405.84	Professional		$299.27	$352.09	$405.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $95.49 / $112.34 / $135.21	Professional	26	$95.49	$112.34	$135.21
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $203.79 / $239.75 / $270.63	Professional	TC	$203.79	$239.75	$270.63
United Facility/Professional Professional Modifier Low / Median / High Price $169.33 / $248.81 / $540.22	Professional		$169.33	$248.81	$540.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $67.26 / $127.01	Professional	26	$51.50	$67.26	$127.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.03 / $197.31 / $395.54	Professional	TC	$115.03	$197.31	$395.54