Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.01 / $84.01 / $84.01	Facility	26	$84.01	$84.01	$84.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.43 / $89.98 / $172.81	Professional		$75.43	$89.98	$172.81
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 $44.21 / $55.84 / $102.20	Professional	TC	$44.21	$55.84	$102.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.21 / $133.55 / $157.12	Professional		$86.21	$133.55	$157.12
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 $47.86 / $78.03 / $89.45	Professional	TC	$47.86	$78.03	$89.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $325.44 / $325.44 / $361.27	Professional		$325.44	$325.44	$361.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $221.81 / $221.81 / $221.81	Professional	26	$221.81	$221.81	$221.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $103.63 / $103.63 / $103.63	Professional	TC	$103.63	$103.63	$103.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $130.22 / $149.97 / $175.22	Professional		$130.22	$149.97	$175.22
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.83 / $60.84 / $71.08	Professional	26	$52.83	$60.84	$71.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.39 / $89.11 / $93.80	Professional	TC	$77.39	$89.11	$93.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $59.63 / $127.79	Professional		$32.34	$59.63	$127.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $143.82 / $169.20 / $197.48	Professional		$143.82	$169.20	$197.48
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 $86.76 / $102.07 / $116.48	Professional	TC	$86.76	$102.07	$116.48
United Facility/Professional Professional Modifier Low / Median / High Price $78.97 / $85.55 / $157.76	Professional		$78.97	$85.55	$157.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $37.61 / $67.31	Professional	26	$33.70	$37.61	$67.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.27 / $50.54 / $90.44	Professional	TC	$45.27	$50.54	$90.44