Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.00 / $60.00 / $60.00	Facility	26	$60.00	$60.00	$60.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.17 / $171.46 / $286.02	Professional		$120.17	$171.46	$286.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.31 / $145.61 / $237.17	Professional	TC	$100.31	$145.61	$237.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.98 / $205.53 / $254.78	Professional		$110.98	$205.53	$254.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.31 / $162.44 / $205.99	Professional	TC	$90.31	$162.44	$205.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $240.37 / $240.37 / $266.83	Professional		$240.37	$240.37	$266.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.95 / $59.95 / $72.51	Professional	26	$59.95	$59.95	$72.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.86 / $167.86 / $206.88	Professional	TC	$167.86	$167.86	$206.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $222.55 / $256.27 / $299.43	Professional		$222.55	$256.27	$299.43
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $185.74 / $197.00 / $225.14	Professional	TC	$185.74	$197.00	$225.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $41.79 / $215.88	Professional		$32.34	$41.79	$215.88
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 $247.46 / $291.13 / $329.72	Professional		$247.46	$291.13	$329.72
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $207.87 / $244.55 / $273.70	Professional	TC	$207.87	$244.55	$273.70
United Facility/Professional Professional Modifier Low / Median / High Price $114.22 / $139.08 / $248.88	Professional		$114.22	$139.08	$248.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.90 / $107.55 / $192.30	Professional	TC	$91.90	$107.55	$192.30