Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.40 / $126.04 / $158.87	Facility	26	$71.40	$126.04	$158.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.72 / $247.94 / $293.51	Professional		$167.72	$247.94	$293.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $62.73 / $123.43	Professional	26	$44.14	$62.73	$123.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.16 / $181.73 / $221.14	Professional	TC	$114.16	$181.73	$221.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.47 / $122.35 / $338.42	Professional		$109.47	$122.35	$338.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $44.30 / $96.05	Professional	26	$39.64	$44.30	$96.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.83 / $78.05 / $248.83	Professional	TC	$69.83	$78.05	$248.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $509.95 / $509.95 / $756.22	Professional		$509.95	$509.95	$756.22
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $248.12 / $248.12 / $249.21	Professional	26	$248.12	$248.12	$249.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $260.74 / $260.74 / $508.10	Professional	TC	$260.74	$260.74	$508.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $211.35 / $243.37 / $316.35	Professional		$211.35	$243.37	$316.35
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.73 / $86.05 / $100.54	Professional	26	$74.73	$86.05	$100.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $136.63 / $157.34 / $183.84	Professional	TC	$136.63	$157.34	$183.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $76.16 / $183.77	Professional		$32.34	$76.16	$183.77
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 $232.90 / $274.00 / $316.35	Professional		$232.90	$274.00	$316.35
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $81.52 / $95.90 / $115.29	Professional	26	$81.52	$95.90	$115.29
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $151.38 / $178.10 / $201.05	Professional	TC	$151.38	$178.10	$201.05
United Facility/Professional Professional Modifier Low / Median / High Price $134.36 / $203.68 / $442.13	Professional		$134.36	$203.68	$442.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.56 / $53.97 / $107.11	Professional	26	$43.56	$53.97	$107.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.80 / $159.41 / $319.57	Professional	TC	$90.80	$159.41	$319.57