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 / $127.10	Facility	26	$71.40	$126.04	$127.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.29 / $247.93 / $286.95	Professional		$167.29	$247.93	$286.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $53.55 / $105.92	Professional	26	$44.14	$53.55	$105.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.74 / $181.03 / $221.14	Professional	TC	$113.74	$181.03	$221.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.21 / $122.06 / $334.07	Professional		$109.21	$122.06	$334.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $44.30 / $90.22	Professional	26	$39.64	$44.30	$90.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.56 / $77.76 / $247.58	Professional	TC	$69.56	$77.76	$247.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $508.91 / $508.91 / $756.22	Professional		$508.91	$508.91	$756.22
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $258.37 / $258.37 / $258.37	Professional	26	$258.37	$258.37	$258.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $250.54 / $250.54 / $497.85	Professional	TC	$250.54	$250.54	$497.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $210.82 / $242.76 / $316.35	Professional		$210.82	$242.76	$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 $136.09 / $156.71 / $183.11	Professional	TC	$136.09	$156.71	$183.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $67.45 / $230.63	Professional		$32.34	$67.45	$230.63
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 $232.32 / $273.32 / $316.35	Professional		$232.32	$273.32	$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 $150.81 / $177.42 / $201.05	Professional	TC	$150.81	$177.42	$201.05
United Facility/Professional Professional Modifier Low / Median / High Price $134.36 / $200.50 / $432.74	Professional		$134.36	$200.50	$432.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.66 / $53.97 / $101.17	Professional	26	$41.66	$53.97	$101.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.80 / $158.84 / $318.43	Professional	TC	$90.80	$158.84	$318.43