Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.36 / $124.36 / $124.36	Facility	26	$124.36	$124.36	$124.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $155.51 / $320.51	Professional		$109.45	$155.51	$320.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $54.90 / $104.51	Professional	26	$29.91	$54.90	$104.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.54 / $105.65 / $216.00	Professional	TC	$79.54	$105.65	$216.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.15 / $248.37 / $298.98	Professional		$144.15	$248.37	$298.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.32 / $72.51 / $94.20	Professional	26	$39.32	$72.51	$94.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.56 / $166.20 / $212.08	Professional	TC	$106.56	$166.20	$212.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $353.80 / $353.80 / $392.75	Professional		$353.80	$353.80	$392.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $219.86 / $219.86 / $220.37	Professional	26	$219.86	$219.86	$220.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.43 / $133.43 / $172.89	Professional	TC	$133.43	$133.43	$172.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $241.25 / $277.80 / $324.58	Professional		$241.25	$277.80	$324.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.39 / $82.08 / $93.80	Professional	26	$77.39	$82.08	$93.80
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $163.85 / $178.54 / $198.60	Professional	TC	$163.85	$178.54	$198.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $81.02 / $263.50	Professional		$32.34	$81.02	$263.50
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 $267.83 / $315.10 / $366.69	Professional		$267.83	$315.10	$366.69
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $84.43 / $99.33 / $120.27	Professional	26	$84.43	$99.33	$120.27
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $183.41 / $215.78 / $246.42	Professional	TC	$183.41	$215.78	$246.42
United Facility/Professional Professional Modifier Low / Median / High Price $151.44 / $164.92 / $295.12	Professional		$151.44	$164.92	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $53.66 / $84.88	Professional	26	$33.70	$53.66	$84.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.58 / $125.60 / $232.47	Professional	TC	$103.58	$125.60	$232.47