Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.85 / $52.72 / $71.15	Facility	26	$40.85	$52.72	$71.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $127.05 / $270.88	Professional		$90.73	$127.05	$270.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.26 / $29.39 / $58.85	Professional	26	$24.26	$29.39	$58.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $99.99 / $212.03	Professional	TC	$66.45	$99.99	$212.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.43 / $191.62 / $243.84	Professional		$109.43	$191.62	$243.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $46.27 / $54.44	Professional	26	$30.20	$46.27	$54.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.18 / $146.02 / $184.56	Professional	TC	$84.18	$146.02	$184.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $318.69 / $318.69 / $456.16	Professional		$318.69	$318.69	$456.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.12 / $86.12 / $121.57	Professional	26	$86.12	$86.12	$121.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $197.12 / $197.12 / $370.04	Professional	TC	$197.12	$197.12	$370.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $199.62 / $229.86 / $268.58	Professional		$199.62	$229.86	$268.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.30 / $51.02 / $56.09	Professional	26	$44.30	$51.02	$56.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $155.31 / $164.73 / $188.26	Professional	TC	$155.31	$164.73	$188.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $49.55 / $193.78	Professional		$32.34	$49.55	$193.78
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $714.15 / $714.15 / $714.15	Facility	26	$714.15	$714.15	$714.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $225.34 / $265.10 / $305.19	Professional		$225.34	$265.10	$305.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $48.91 / $57.54 / $67.23	Professional	26	$48.91	$57.54	$67.23
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $176.42 / $207.55 / $237.96	Professional	TC	$176.42	$207.55	$237.96
United Facility/Professional Professional Modifier Low / Median / High Price $106.54 / $131.86 / $229.61	Professional		$106.54	$131.86	$229.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $31.93 / $60.64	Professional	26	$28.25	$31.93	$60.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.29 / $94.91 / $169.33	Professional	TC	$78.29	$94.91	$169.33