Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.55 / $83.55 / $83.55	Facility	26	$83.55	$83.55	$83.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $93.64 / $153.08	Professional		$70.09	$93.64	$153.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.24 / $33.40 / $67.41	Professional	26	$26.24	$33.40	$67.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.46 / $56.15 / $85.66	Professional	TC	$39.46	$56.15	$85.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $122.03 / $185.98	Professional		$84.57	$122.03	$185.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.50 / $49.40 / $64.86	Professional	26	$33.50	$49.40	$64.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.63 / $70.48 / $108.01	Professional	TC	$48.63	$70.48	$108.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $186.35 / $186.35 / $307.58	Professional		$186.35	$186.35	$307.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.93 / $89.93 / $108.77	Professional	26	$89.93	$89.93	$108.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.58 / $77.58 / $217.65	Professional	TC	$77.58	$77.58	$217.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $119.01 / $133.44 / $176.97	Professional		$119.01	$133.44	$176.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.23 / $55.89 / $62.10	Professional	26	$51.23	$55.89	$62.10
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.78 / $73.94 / $82.16	Professional	TC	$67.78	$73.94	$82.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $58.19 / $130.63	Professional		$32.34	$58.19	$130.63
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $131.01 / $154.13 / $176.97	Professional		$131.01	$154.13	$176.97
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $55.32 / $65.08 / $78.18	Professional	26	$55.32	$65.08	$78.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $75.69 / $89.05 / $98.79	Professional	TC	$75.69	$89.05	$98.79
United Facility/Professional Professional Modifier Low / Median / High Price $91.90 / $106.78 / $183.60	Professional		$91.90	$106.78	$183.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.38 / $38.76 / $69.36	Professional	26	$34.38	$38.76	$69.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.52 / $77.52 / $114.91	Professional	TC	$57.52	$77.52	$114.91