Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.54 / $126.04 / $127.10	Facility	26	$68.54	$126.04	$127.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.87 / $247.94 / $326.32	Professional		$166.87	$247.94	$326.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $62.65 / $120.74	Professional	26	$44.14	$62.65	$120.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.31 / $180.34 / $221.14	Professional	TC	$113.31	$180.34	$221.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.95 / $121.77 / $337.07	Professional		$108.95	$121.77	$337.07
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 $69.31 / $77.47 / $246.34	Professional	TC	$69.31	$77.47	$246.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $511.15 / $511.15 / $803.48	Professional		$511.15	$511.15	$803.48
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $256.83 / $256.83 / $256.83	Professional	26	$256.83	$256.83	$256.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $254.31 / $254.31 / $546.64	Professional	TC	$254.31	$254.31	$546.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $210.29 / $242.16 / $314.81	Professional		$210.29	$242.16	$314.81
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 $135.56 / $156.10 / $182.40	Professional	TC	$135.56	$156.10	$182.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $84.86 / $206.45	Professional		$32.34	$84.86	$206.45
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 $231.16 / $271.95 / $314.81	Professional		$231.16	$271.95	$314.81
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 $149.63 / $176.05 / $199.52	Professional	TC	$149.63	$176.05	$199.52
United Facility/Professional Professional Modifier Low / Median / High Price $133.75 / $199.92 / $400.78	Professional		$133.75	$199.92	$400.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.66 / $53.96 / $101.17	Professional	26	$41.66	$53.96	$101.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.19 / $158.26 / $328.63	Professional	TC	$90.19	$158.26	$328.63