Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.15 / $96.15 / $96.95	Facility	26	$96.15	$96.15	$96.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $125.94 / $255.12	Professional		$101.04	$125.94	$255.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $42.93 / $88.29	Professional	26	$29.91	$42.93	$88.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.14 / $92.66 / $174.32	Professional	TC	$71.14	$92.66	$174.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.73 / $194.12 / $229.87	Professional		$106.73	$194.12	$229.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.59 / $59.79 / $72.83	Professional	26	$37.59	$59.79	$72.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.09 / $131.86 / $155.13	Professional	TC	$72.09	$131.86	$155.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $308.22 / $308.22 / $495.59	Professional		$308.22	$308.22	$495.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $137.66 / $137.66 / $150.82	Professional	26	$137.66	$137.66	$150.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $157.40 / $157.40 / $357.92	Professional	TC	$157.40	$157.40	$357.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $197.50 / $231.84 / $292.97	Professional		$197.50	$231.84	$292.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.85 / $70.06 / $73.76	Professional	26	$60.85	$70.06	$73.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $132.36 / $140.38 / $160.44	Professional	TC	$132.36	$140.38	$160.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $68.80 / $188.97	Professional		$32.34	$68.80	$188.97
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 $214.27 / $252.08 / $292.97	Professional		$214.27	$252.08	$292.97
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $65.80 / $77.41 / $93.46	Professional	26	$65.80	$77.41	$93.46
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $148.47 / $174.68 / $199.52	Professional	TC	$148.47	$174.68	$199.52
United Facility/Professional Professional Modifier Low / Median / High Price $113.86 / $128.82 / $230.51	Professional		$113.86	$128.82	$230.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $41.50 / $71.94	Professional	26	$34.04	$41.50	$71.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.41 / $82.71 / $155.52	Professional	TC	$78.41	$82.71	$155.52