Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.95 / $50.94 / $51.37	Facility	26	$44.95	$50.94	$51.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $108.45 / $197.94	Professional		$73.73	$108.45	$197.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $22.47 / $48.80	Professional	26	$18.16	$22.47	$48.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $78.34 / $155.13	Professional	TC	$55.57	$78.34	$155.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.34 / $150.43 / $176.98	Professional		$83.34	$150.43	$176.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.48 / $33.14 / $38.99	Professional	26	$22.48	$33.14	$38.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.05 / $114.26 / $136.75	Professional	TC	$65.05	$114.26	$136.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $294.38 / $294.38 / $326.79	Professional		$294.38	$294.38	$326.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.61 / $135.61 / $135.61	Professional	26	$135.61	$135.61	$135.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $158.77 / $158.77 / $158.77	Professional	TC	$158.77	$158.77	$158.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $157.44 / $181.30 / $231.34	Professional		$157.44	$181.30	$231.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.03 / $36.88 / $38.82	Professional	26	$32.03	$36.88	$38.82
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.42 / $144.41 / $152.02	Professional	TC	$125.42	$144.41	$152.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $36.17 / $152.76	Professional		$32.34	$36.17	$152.76
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 $172.35 / $202.76 / $231.34	Professional		$172.35	$202.76	$231.34
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $40.42 / $49.13	Professional	26	$34.36	$40.42	$49.13
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $138.00 / $162.35 / $182.21	Professional	TC	$138.00	$162.35	$182.21
United Facility/Professional Professional Modifier Low / Median / High Price $77.27 / $99.28 / $174.80	Professional		$77.27	$99.28	$174.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $22.42 / $40.11	Professional	26	$19.73	$22.42	$40.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.53 / $73.26 / $130.13	Professional	TC	$57.53	$73.26	$130.13