Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.26 / $118.71 / $119.71	Facility	26	$68.26	$118.71	$119.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.67 / $221.64 / $613.82	Professional		$110.67	$221.64	$613.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $72.81 / $193.93	Professional	26	$42.60	$72.81	$193.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.48 / $87.44 / $159.88	Professional	TC	$64.48	$87.44	$159.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.25 / $179.82 / $230.39	Professional		$118.25	$179.82	$230.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.64 / $73.09 / $94.03	Professional	26	$49.64	$73.09	$94.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.61 / $105.50 / $135.51	Professional	TC	$68.61	$105.50	$135.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $264.64 / $264.64 / $293.83	Professional		$264.64	$264.64	$293.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $228.61 / $228.61 / $241.32	Professional	26	$228.61	$228.61	$241.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.33 / $23.33 / $65.22	Professional	TC	$23.33	$23.33	$65.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $186.27 / $203.20 / $254.38	Professional		$186.27	$203.20	$254.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.73 / $79.26 / $90.58	Professional	26	$74.73	$79.26	$90.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $90.58 / $118.30 / $135.19	Professional	TC	$90.58	$118.30	$135.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $84.81 / $204.22	Professional		$32.34	$84.81	$204.22
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 $204.95 / $241.12 / $279.35	Professional		$204.95	$241.12	$279.35
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $80.94 / $95.22 / $115.20	Professional	26	$80.94	$95.22	$115.20
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $124.02 / $145.91 / $164.15	Professional	TC	$124.02	$145.91	$164.15
United Facility/Professional Professional Modifier Low / Median / High Price $124.51 / $149.41 / $243.82	Professional		$124.51	$149.41	$243.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.34 / $51.20 / $95.89	Professional	26	$48.34	$51.20	$95.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.62 / $83.39 / $154.35	Professional	TC	$73.62	$83.39	$154.35