Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.76 / $64.03 / $64.88	Facility	26	$36.76	$64.03	$64.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.81 / $125.77 / $261.20	Professional		$82.81	$125.77	$261.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $28.72 / $60.14	Professional	26	$22.87	$28.72	$60.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.92 / $100.71 / $207.40	Professional	TC	$59.92	$100.71	$207.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.37 / $196.65 / $242.24	Professional		$106.37	$196.65	$242.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.08 / $42.31 / $49.78	Professional	26	$29.08	$42.31	$49.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.52 / $157.21 / $188.61	Professional	TC	$83.52	$157.21	$188.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $351.10 / $351.10 / $583.39	Professional		$351.10	$351.10	$583.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $170.54 / $170.54 / $170.54	Professional	26	$170.54	$170.54	$170.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $180.56 / $180.56 / $412.85	Professional	TC	$180.56	$180.56	$412.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $194.80 / $224.31 / $262.08	Professional		$194.80	$224.31	$262.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.03 / $46.09 / $53.86	Professional	26	$40.03	$46.09	$53.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.77 / $164.15 / $187.60	Professional	TC	$154.77	$164.15	$187.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $45.18 / $167.71	Professional		$32.34	$45.18	$167.71
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 $217.76 / $256.19 / $296.64	Professional		$217.76	$256.19	$296.64
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $51.38 / $61.75	Professional	26	$43.67	$51.38	$61.75
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $174.10 / $204.82 / $234.88	Professional	TC	$174.10	$204.82	$234.88
United Facility/Professional Professional Modifier Low / Median / High Price $93.94 / $131.37 / $220.52	Professional		$93.94	$131.37	$220.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.87 / $28.50 / $52.27	Professional	26	$25.87	$28.50	$52.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.06 / $104.30 / $173.82	Professional	TC	$68.06	$104.30	$173.82