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 $109.36 / $247.65 / $326.32	Professional		$109.36	$247.65	$326.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $63.55 / $120.74	Professional	26	$43.82	$63.55	$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 / $331.16	Professional		$108.95	$121.77	$331.16
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 $231.80 / $231.80 / $231.80	Professional	50	$231.80	$231.80	$231.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.31 / $77.47 / $245.71	Professional	TC	$69.31	$77.47	$245.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $615.16 / $615.16 / $711.66	Professional		$615.16	$615.16	$711.66
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 $234.79 / $234.79 / $330.50	Professional	TC	$234.79	$234.79	$330.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $210.82 / $242.76 / $315.57	Professional		$210.82	$242.76	$315.57
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 $136.09 / $156.71 / $183.11	Professional	TC	$136.09	$156.71	$183.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $84.86 / $206.97	Professional		$32.34	$84.86	$206.97
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 $231.74 / $272.63 / $315.58	Professional		$231.74	$272.63	$315.58
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 $150.22 / $176.73 / $200.28	Professional	TC	$150.22	$176.73	$200.28
United Facility/Professional Professional Modifier Low / Median / High Price $133.75 / $197.61 / $396.15	Professional		$133.75	$197.61	$396.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.96 / $53.96 / $102.61	Professional	26	$41.96	$53.96	$102.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.19 / $155.65 / $274.37	Professional	TC	$90.19	$155.65	$274.37