Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.15 / $103.15 / $103.15	Facility	26	$103.15	$103.15	$103.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.75 / $151.27 / $222.97	Professional		$104.75	$151.27	$222.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.45 / $100.62 / $139.25	Professional	TC	$69.45	$100.62	$139.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.63 / $169.60 / $208.12	Professional		$108.63	$169.60	$208.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.35 / $104.29 / $128.88	Professional	TC	$61.35	$104.29	$128.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $507.75 / $507.75 / $563.65	Professional		$507.75	$507.75	$563.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $278.61 / $278.61 / $336.98	Professional	26	$278.61	$278.61	$336.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $170.77 / $170.77 / $285.04	Professional	TC	$170.77	$170.77	$285.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $172.92 / $199.12 / $258.64	Professional		$172.92	$199.12	$258.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.41 / $125.99 / $147.21	Professional	TC	$109.41	$125.99	$147.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $71.84 / $169.59	Professional		$32.34	$71.84	$169.59
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,387.45 / $1,387.45 / $1,387.45	Facility	26	$1,387.45	$1,387.45	$1,387.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $190.40 / $224.00 / $258.64	Professional		$190.40	$224.00	$258.64
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $121.69 / $143.16 / $161.84	Professional	TC	$121.69	$143.16	$161.84
United Facility/Professional Professional Modifier Low / Median / High Price $104.66 / $134.44 / $248.85	Professional		$104.66	$134.44	$248.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.80 / $93.94 / $173.87	Professional	TC	$62.80	$93.94	$173.87