Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.17 / $48.05 / $105.89	Facility	26	$43.17	$48.05	$105.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.89 / $122.84 / $229.05	Professional		$99.89	$122.84	$229.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.21 / $35.77 / $70.59	Professional	26	$31.21	$35.77	$70.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.67 / $87.37 / $158.44	Professional	TC	$68.67	$87.37	$158.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.88 / $176.45 / $207.59	Professional		$112.88	$176.45	$207.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.97 / $52.25 / $65.31	Professional	26	$35.97	$52.25	$65.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.53 / $120.94 / $138.63	Professional	TC	$74.53	$120.94	$138.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $430.77 / $430.77 / $562.26	Professional		$430.77	$430.77	$562.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $221.91 / $221.91 / $221.91	Professional	26	$221.91	$221.91	$221.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.86 / $208.86 / $208.86	Professional	TC	$208.86	$208.86	$208.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $172.92 / $199.12 / $232.66	Professional		$172.92	$199.12	$232.66
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.83 / $60.84 / $64.04	Professional	26	$52.83	$60.84	$64.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.09 / $138.28 / $145.56	Professional	TC	$120.09	$138.28	$145.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $59.35 / $188.21	Professional		$32.34	$59.35	$188.21
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 $191.56 / $225.37 / $262.83	Professional		$191.56	$225.37	$262.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $57.06 / $67.13 / $81.00	Professional	26	$57.06	$67.13	$81.00
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $134.50 / $158.22 / $181.83	Professional	TC	$134.50	$158.22	$181.83
United Facility/Professional Professional Modifier Low / Median / High Price $104.16 / $116.28 / $208.07	Professional		$104.16	$116.28	$208.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $37.63 / $67.31	Professional	26	$33.70	$37.63	$67.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.45 / $78.65 / $148.54	Professional	TC	$70.45	$78.65	$148.54