Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.82 / $150.53 / $151.79	Facility	26	$132.82	$150.53	$151.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.15 / $249.83 / $304.05	Professional		$175.15	$249.83	$304.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $63.53 / $126.50	Professional	26	$51.28	$63.53	$126.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.61 / $177.56 / $220.00	Professional	TC	$111.61	$177.56	$220.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.37 / $128.94 / $332.24	Professional		$115.37	$128.94	$332.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.10 / $52.64 / $107.30	Professional	26	$47.10	$52.64	$107.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.27 / $76.30 / $224.76	Professional	TC	$68.27	$76.30	$224.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $719.76 / $719.76 / $799.00	Professional		$719.76	$719.76	$799.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $451.13 / $451.13 / $452.05	Professional	26	$451.13	$451.13	$452.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $267.70 / $267.70 / $347.87	Professional	TC	$267.70	$267.70	$347.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $221.50 / $255.06 / $334.23	Professional		$221.50	$255.06	$334.23
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $108.04 / $160.44	Professional	26	$89.13	$108.04	$160.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $132.36 / $152.41 / $178.09	Professional	TC	$132.36	$152.41	$178.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $101.15 / $217.98	Professional		$32.34	$101.15	$217.98
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 $244.55 / $287.70 / $334.23	Professional		$244.55	$287.70	$334.23
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.24 / $114.40 / $137.79	Professional	26	$97.24	$114.40	$137.79
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $147.31 / $173.30 / $196.44	Professional	TC	$147.31	$173.30	$196.44
United Facility/Professional Professional Modifier Low / Median / High Price $128.84 / $197.61 / $367.24	Professional		$128.84	$197.61	$367.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.48 / $64.22 / $119.72	Professional	26	$49.48	$64.22	$119.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.00 / $130.53 / $258.31	Professional	TC	$77.00	$130.53	$258.31