Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.47 / $100.05 / $100.05	Facility	26	$54.47	$100.05	$100.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.73 / $98.77 / $275.00	Professional		$83.73	$98.77	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $42.56 / $114.56	Professional	26	$34.07	$42.56	$114.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $61.85 / $83.93	Professional	TC	$40.65	$61.85	$83.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.83 / $119.23 / $144.57	Professional		$83.83	$119.23	$144.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.64 / $62.93 / $74.04	Professional	26	$42.64	$62.93	$74.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $52.23 / $72.12	Professional	TC	$36.97	$52.23	$72.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $374.06 / $374.06 / $512.64	Professional		$374.06	$374.06	$512.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $214.95 / $214.95 / $301.02	Professional	26	$214.95	$214.95	$301.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.04 / $73.04 / $73.04	Professional	TC	$73.04	$73.04	$73.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $127.02 / $146.26 / $179.85	Professional		$127.02	$146.26	$179.85
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.78 / $72.45 / $81.52	Professional	26	$59.78	$72.45	$81.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.25 / $77.44 / $90.49	Professional	TC	$67.25	$77.44	$90.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $60.67 / $110.65	Professional		$32.34	$60.67	$110.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $136.25 / $160.29 / $179.86	Professional		$136.25	$160.29	$179.86
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $65.20 / $76.72 / $91.83	Professional	26	$65.20	$76.72	$91.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $67.20 / $83.57 / $88.03	Professional	TC	$67.20	$83.57	$88.03
United Facility/Professional Professional Modifier Low / Median / High Price $62.27 / $82.74 / $174.37	Professional		$62.27	$82.74	$174.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.70 / $42.94 / $80.37	Professional	26	$32.70	$42.94	$80.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.61 / $41.66 / $94.00	Professional	TC	$27.61	$41.66	$94.00