Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.97 / $167.97 / $208.09	Facility	26	$167.97	$167.97	$208.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.93 / $216.21 / $258.80	Professional		$155.93	$216.21	$258.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $58.13 / $138.72	Professional	26	$49.65	$58.13	$138.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.47 / $142.88 / $180.05	Professional	TC	$69.47	$142.88	$180.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.75 / $221.81 / $289.93	Professional		$154.75	$221.81	$289.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.60 / $99.23 / $124.76	Professional	26	$63.60	$99.23	$124.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.93 / $106.57 / $171.23	Professional	TC	$79.93	$106.57	$171.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $459.13 / $459.13 / $509.68	Professional		$459.13	$459.13	$509.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $179.42 / $179.42 / $368.97	Professional	26	$179.42	$179.42	$368.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $90.16 / $90.16 / $330.26	Professional	TC	$90.16	$90.16	$330.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $200.67 / $231.08 / $296.08	Professional		$200.67	$231.08	$296.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.74 / $120.08 / $129.38	Professional	26	$106.74	$120.08	$129.38
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.93 / $108.17 / $128.09	Professional	TC	$93.93	$108.17	$128.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $92.98 / $195.20	Professional		$32.34	$92.98	$195.20
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,551.62 / $5,551.62 / $5,551.62	Facility	26	$5,551.62	$5,551.62	$5,551.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $220.68 / $259.62 / $296.08	Professional		$220.68	$259.62	$296.08
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $115.87 / $136.32 / $158.08	Professional	26	$115.87	$136.32	$158.08
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $104.81 / $123.30 / $138.01	Professional	TC	$104.81	$123.30	$138.01
United Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $188.23 / $348.39	Professional		$141.47	$188.23	$348.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.16 / $75.62 / $127.05	Professional	26	$56.16	$75.62	$127.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.65 / $131.22 / $225.04	Professional	TC	$69.65	$131.22	$225.04