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 $84.88 / $247.66 / $328.65	Professional		$84.88	$247.66	$328.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $55.00 / $105.92	Professional	26	$43.82	$55.00	$105.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.44 / $220.00 / $253.91	Professional	TC	$132.44	$220.00	$253.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.09 / $154.33 / $333.02	Professional		$138.09	$154.33	$333.02
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 50 Low / Median / High Price $231.34 / $231.34 / $231.34	Professional	50	$231.34	$231.34	$231.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.45 / $110.03 / $249.63	Professional	TC	$98.45	$110.03	$249.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $735.96 / $735.96 / $905.35	Professional		$735.96	$735.96	$905.35
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $380.38 / $380.38 / $381.16	Professional	26	$380.38	$380.38	$381.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.80 / $354.80 / $524.97	Professional	TC	$354.80	$354.80	$524.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $260.98 / $300.52 / $394.00	Professional		$260.98	$300.52	$394.00
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 $186.27 / $214.49 / $250.62	Professional	TC	$186.27	$214.49	$250.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $84.86 / $216.78	Professional		$32.34	$84.86	$216.78
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 $288.80 / $339.76 / $394.00	Professional		$288.80	$339.76	$394.00
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 $207.28 / $243.86 / $278.70	Professional	TC	$207.28	$243.86	$278.70
United Facility/Professional Professional Modifier Low / Median / High Price $154.30 / $197.32 / $395.57	Professional		$154.30	$197.32	$395.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.25 / $53.96 / $102.50	Professional	26	$42.25	$53.96	$102.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.74 / $155.07 / $310.88	Professional	TC	$110.74	$155.07	$310.88