Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.84 / $120.84 / $121.85	Facility	26	$120.84	$120.84	$121.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.97 / $174.28 / $267.29	Professional		$145.97	$174.28	$267.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $51.11 / $101.55	Professional	26	$42.14	$51.11	$101.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.44 / $129.29 / $165.99	Professional	TC	$98.44	$129.29	$165.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.48 / $124.60 / $260.00	Professional		$111.48	$124.60	$260.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $42.48 / $87.11	Professional	26	$38.01	$42.48	$87.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.47 / $82.12 / $179.72	Professional	TC	$73.47	$82.12	$179.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $445.63 / $445.63 / $494.69	Professional		$445.63	$445.63	$494.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $238.87 / $238.87 / $366.78	Professional	26	$238.87	$238.87	$366.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $127.91 / $206.76	Professional	TC	$127.91	$127.91	$206.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $212.42 / $244.61 / $319.99	Professional		$212.42	$244.61	$319.99
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.51 / $82.35 / $96.21	Professional	26	$71.51	$82.35	$96.21
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $140.88 / $162.24 / $189.57	Professional	TC	$140.88	$162.24	$189.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.70 / $208.15	Professional		$32.34	$72.70	$208.15
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $156.94 / $156.94 / $156.94	Facility	26	$156.94	$156.94	$156.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $234.06 / $275.37 / $319.99	Professional		$234.06	$275.37	$319.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $78.02 / $91.79 / $110.48	Professional	26	$78.02	$91.79	$110.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $156.04 / $183.58 / $209.51	Professional	TC	$156.04	$183.58	$209.51
United Facility/Professional Professional Modifier Low / Median / High Price $124.85 / $168.40 / $308.56	Professional		$124.85	$168.40	$308.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.50 / $52.06 / $97.99	Professional	26	$40.50	$52.06	$97.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.82 / $113.42 / $227.36	Professional	TC	$82.82	$113.42	$227.36