Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.43 / $71.88 / $82.65	Facility	26	$63.43	$71.88	$82.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $102.58 / $202.98	Professional		$81.68	$102.58	$202.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $32.11 / $61.97	Professional	26	$19.89	$32.11	$61.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.79 / $76.95 / $142.56	Professional	TC	$61.79	$76.95	$142.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.40 / $153.53 / $184.70	Professional		$86.40	$153.53	$184.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.18 / $44.17 / $60.57	Professional	26	$25.18	$44.17	$60.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.22 / $105.31 / $128.19	Professional	TC	$61.22	$105.31	$128.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $216.06 / $216.06 / $239.85	Professional		$216.06	$216.06	$239.85
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $88.17 / $88.17 / $215.75	Professional	26	$88.17	$88.17	$215.75
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.31 / $0.31 / $151.68	Professional	TC	$0.31	$0.31	$151.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $153.71 / $177.00 / $206.82	Professional		$153.71	$177.00	$206.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $48.19 / $54.98	Professional	26	$45.36	$48.19	$54.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $108.34 / $114.91 / $131.32	Professional	TC	$108.34	$114.91	$131.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $51.32 / $167.29	Professional		$32.34	$51.32	$167.29
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $346.39	Facility	26	$346.39	$346.39	$346.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $170.02 / $200.02 / $233.47	Professional		$170.02	$200.02	$233.47
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $48.91 / $57.54 / $70.09	Professional	26	$48.91	$57.54	$70.09
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $121.11 / $142.47 / $163.38	Professional	TC	$121.11	$142.47	$163.38
United Facility/Professional Professional Modifier Low / Median / High Price $89.15 / $102.98 / $184.27	Professional		$89.15	$102.98	$184.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $32.31 / $57.81	Professional	26	$22.46	$32.31	$57.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.52 / $70.12 / $126.46	Professional	TC	$65.52	$70.12	$126.46