Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.60 / $43.60 / $43.60	Facility	26	$43.60	$43.60	$43.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $95.90 / $158.03	Professional		$61.64	$95.90	$158.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.61 / $17.96 / $36.64	Professional	26	$15.61	$17.96	$36.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $60.81 / $121.39	Professional	TC	$46.00	$60.81	$121.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.80 / $122.18 / $143.74	Professional		$69.80	$122.18	$143.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $28.81 / $33.90	Professional	26	$19.38	$28.81	$33.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.56 / $93.37 / $109.18	Professional	TC	$51.56	$93.37	$109.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.77 / $245.77 / $272.83	Professional		$245.77	$245.77	$272.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.12 / $117.12 / $117.12	Professional	26	$117.12	$117.12	$117.12
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $128.65 / $128.65 / $128.65	Professional	TC	$128.65	$128.65	$128.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.09 / $147.50 / $172.34	Professional		$128.09	$147.50	$172.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $31.35 / $33.00	Professional	26	$27.23	$31.35	$33.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.86 / $116.15 / $123.72	Professional	TC	$100.86	$116.15	$123.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.79 / $32.34 / $138.65	Professional		$27.79	$32.34	$138.65
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 $138.58 / $163.03 / $184.67	Professional		$138.58	$163.03	$184.67
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $29.70 / $34.94 / $42.05	Professional	26	$29.70	$34.94	$42.05
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $108.89 / $128.10 / $142.62	Professional	TC	$108.89	$128.10	$142.62
United Facility/Professional Professional Modifier Low / Median / High Price $64.67 / $83.98 / $146.30	Professional		$64.67	$83.98	$146.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $19.76 / $35.36	Professional	26	$17.02	$19.76	$35.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.65 / $64.22 / $107.79	Professional	TC	$47.65	$64.22	$107.79