Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.41 / $137.00 / $137.00	Facility	26	$74.41	$137.00	$137.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.03 / $246.41 / $294.77	Professional		$171.03	$246.41	$294.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $55.00 / $115.13	Professional	26	$46.78	$55.00	$115.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.89 / $179.64 / $220.00	Professional	TC	$112.89	$179.64	$220.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.14 / $125.34 / $326.48	Professional		$112.14	$125.34	$326.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.09 / $48.16 / $97.96	Professional	26	$43.09	$48.16	$97.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.05 / $77.18 / $227.47	Professional	TC	$69.05	$77.18	$227.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $487.01 / $487.01 / $746.77	Professional		$487.01	$487.01	$746.77
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $228.25 / $228.25 / $403.20	Professional	26	$228.25	$228.25	$403.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.81 / $83.81 / $518.52	Professional	TC	$83.81	$83.81	$518.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $134.49 / $229.25 / $324.85	Professional		$134.49	$229.25	$324.85
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.66 / $94.03 / $109.87	Professional	26	$81.66	$94.03	$109.87
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.49 / $154.87 / $180.95	Professional	TC	$134.49	$154.87	$180.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $83.06 / $236.59	Professional		$32.34	$83.06	$236.59
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 $238.14 / $280.16 / $324.85	Professional		$238.14	$280.16	$324.85
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $89.09 / $104.81 / $126.10	Professional	26	$89.09	$104.81	$126.10
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $149.06 / $175.36 / $198.75	Professional	TC	$149.06	$175.36	$198.75
United Facility/Professional Professional Modifier Low / Median / High Price $125.47 / $193.55 / $371.69	Professional		$125.47	$193.55	$371.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.85 / $58.52 / $108.51	Professional	26	$44.85	$58.52	$108.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.23 / $140.25 / $261.89	Professional	TC	$78.23	$140.25	$261.89