Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.20 / $69.30 / $69.30	Facility	26	$40.20	$69.30	$69.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $104.50 / $348.88	Professional		$56.16	$104.50	$348.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $29.52 / $65.51	Professional	26	$25.26	$29.52	$65.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.22 / $72.23 / $98.75	Professional	TC	$26.22	$72.23	$98.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $92.34 / $143.59	Professional		$62.10	$92.34	$143.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.19 / $42.59 / $55.85	Professional	26	$29.19	$42.59	$55.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.49 / $47.12 / $77.05	Professional	TC	$32.49	$47.12	$77.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $263.32 / $263.32 / $338.55	Professional		$263.32	$263.32	$338.55
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $111.98 / $111.98 / $143.83	Professional	26	$111.98	$111.98	$143.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.34 / $151.34 / $194.72	Professional	TC	$151.34	$151.34	$194.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $105.97 / $139.47	Professional		$97.14	$105.97	$139.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.76 / $47.74 / $53.04	Professional	26	$43.76	$47.74	$53.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.38 / $56.61 / $64.70	Professional	TC	$53.38	$56.61	$64.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $48.94 / $106.47	Professional		$32.34	$48.94	$106.47
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 $104.23 / $122.62 / $139.47	Professional		$104.23	$122.62	$139.47
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.17 / $55.49 / $66.83	Professional	26	$47.17	$55.49	$66.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $56.88 / $67.13 / $72.65	Professional	TC	$56.88	$67.13	$72.65
United Facility/Professional Professional Modifier Low / Median / High Price $59.91 / $104.65 / $201.95	Professional		$59.91	$104.65	$201.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $31.16 / $55.75	Professional	26	$28.25	$31.16	$55.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $56.29 / $155.60	Professional	TC	$30.32	$56.29	$155.60