Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.96 / $90.97 / $90.97	Facility	26	$51.96	$90.97	$90.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.84 / $164.72 / $302.02	Professional		$98.84	$164.72	$302.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.29 / $38.01 / $76.45	Professional	26	$24.29	$38.01	$76.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.55 / $127.51 / $225.58	Professional	TC	$74.55	$127.51	$225.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.94 / $226.94 / $290.77	Professional		$143.94	$226.94	$290.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $55.74 / $72.48	Professional	26	$37.99	$55.74	$72.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.32 / $170.36 / $218.51	Professional	TC	$103.32	$170.36	$218.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $405.12 / $405.12 / $449.72	Professional		$405.12	$405.12	$449.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.63 / $173.63 / $173.63	Professional	26	$173.63	$173.63	$173.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $231.49 / $231.49 / $231.49	Professional	TC	$231.49	$231.49	$231.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $233.77 / $261.49 / $313.43	Professional		$233.77	$261.49	$313.43
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.11 / $60.57 / $69.22	Professional	26	$57.11	$60.57	$69.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $176.67 / $187.37 / $214.14	Professional	TC	$176.67	$187.37	$214.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $64.56 / $253.58	Professional		$32.34	$64.56	$253.58
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 $257.35 / $302.77 / $347.57	Professional		$257.35	$302.77	$347.57
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $61.72 / $72.61 / $87.71	Professional	26	$61.72	$72.61	$87.71
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $195.64 / $230.16 / $259.87	Professional	TC	$195.64	$230.16	$259.87
United Facility/Professional Professional Modifier Low / Median / High Price $156.22 / $167.58 / $299.89	Professional		$156.22	$167.58	$299.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.76 / $41.42 / $74.13	Professional	26	$36.76	$41.42	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.47 / $125.81 / $225.76	Professional	TC	$119.47	$125.81	$225.76