Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.24 / $65.83 / $66.70	Facility	26	$38.24	$65.83	$66.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.54 / $101.35 / $215.75	Professional		$82.54	$101.35	$215.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $27.39 / $55.32	Professional	26	$23.55	$27.39	$55.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.79 / $73.73 / $160.43	Professional	TC	$56.79	$73.73	$160.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.93 / $160.15 / $205.19	Professional		$97.93	$160.15	$205.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $40.72 / $52.38	Professional	26	$27.46	$40.72	$52.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.42 / $115.66 / $148.40	Professional	TC	$71.42	$115.66	$148.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $344.35 / $344.35 / $382.26	Professional		$344.35	$344.35	$382.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.86 / $69.86 / $85.46	Professional	26	$69.86	$69.86	$85.46
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $274.49 / $274.49 / $274.49	Professional	TC	$274.49	$274.49	$274.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $170.79 / $186.32 / $229.79	Professional		$170.79	$186.32	$229.79
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.10 / $43.59 / $49.82	Professional	26	$41.10	$43.59	$49.82
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.69 / $137.55 / $157.19	Professional	TC	$129.69	$137.55	$157.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.45 / $185.33	Professional		$32.34	$46.45	$185.33
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 $185.60 / $219.20 / $249.92	Professional		$185.60	$219.20	$249.92
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $44.84 / $52.75 / $63.48	Professional	26	$44.84	$52.75	$63.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $140.94 / $166.46 / $186.45	Professional	TC	$140.94	$166.46	$186.45
United Facility/Professional Professional Modifier Low / Median / High Price $108.78 / $117.08 / $218.28	Professional		$108.78	$117.08	$218.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $29.64 / $53.04	Professional	26	$28.15	$29.64	$53.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.54 / $87.70 / $165.24	Professional	TC	$78.54	$87.70	$165.24