Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.26 / $119.49 / $122.58	Facility	26	$68.26	$119.49	$122.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.21 / $224.11 / $581.39	Professional		$129.21	$224.11	$581.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $73.40 / $178.04	Professional	26	$42.60	$73.40	$178.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.30 / $102.67 / $189.38	Professional	TC	$80.30	$102.67	$189.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.77 / $206.26 / $269.86	Professional		$135.77	$206.26	$269.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.97 / $73.61 / $94.65	Professional	26	$49.97	$73.61	$94.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.61 / $131.94 / $169.25	Professional	TC	$85.61	$131.94	$169.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $393.49 / $393.49 / $509.57	Professional		$393.49	$393.49	$509.57
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $184.55 / $184.55 / $230.67	Professional	26	$184.55	$184.55	$230.67
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.82 / $162.82 / $325.02	Professional	TC	$162.82	$162.82	$325.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $214.55 / $234.05 / $288.67	Professional		$214.55	$234.05	$288.67
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.26 / $82.10 / $91.22	Professional	26	$75.26	$82.10	$91.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $139.29 / $147.74 / $168.84	Professional	TC	$139.29	$147.74	$168.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $85.37 / $234.29	Professional		$32.34	$85.37	$234.29
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 $236.98 / $278.80 / $320.48	Professional		$236.98	$278.80	$320.48
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $81.52 / $95.90 / $115.97	Professional	26	$81.52	$95.90	$115.97
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $155.47 / $182.90 / $204.51	Professional	TC	$155.47	$182.90	$204.51
United Facility/Professional Professional Modifier Low / Median / High Price $142.55 / $152.49 / $282.24	Professional		$142.55	$152.49	$282.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.33 / $51.56 / $96.31	Professional	26	$48.33	$51.56	$96.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.66 / $104.16 / $192.79	Professional	TC	$91.66	$104.16	$192.79