Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.93 / $102.99 / $103.85	Facility	26	$58.93	$102.99	$103.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.44 / $186.86 / $528.39	Professional		$93.44	$186.86	$528.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $62.76 / $219.00	Professional	26	$36.61	$62.76	$219.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.79 / $69.69 / $137.27	Professional	TC	$54.79	$69.69	$137.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.91 / $167.59 / $219.45	Professional		$104.91	$167.59	$219.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.32 / $63.10 / $81.84	Professional	26	$42.32	$63.10	$81.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.68 / $103.54 / $132.54	Professional	TC	$66.68	$103.54	$132.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $255.29 / $255.29 / $314.76	Professional		$255.29	$255.29	$314.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $157.88 / $157.88 / $216.18	Professional	26	$157.88	$157.88	$216.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.40 / $97.40 / $98.58	Professional	TC	$97.40	$97.40	$98.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.46 / $194.49 / $233.39	Professional		$173.46	$194.49	$233.39
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.05 / $67.94 / $77.64	Professional	26	$64.05	$67.94	$77.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.41 / $116.04 / $132.62	Professional	TC	$109.41	$116.04	$132.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $73.11 / $152.00	Professional		$32.34	$73.11	$152.00
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 $192.14 / $226.05 / $259.62	Professional		$192.14	$226.05	$259.62
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $69.87 / $82.20 / $99.31	Professional	26	$69.87	$82.20	$99.31
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $122.27 / $143.85 / $160.30	Professional	TC	$122.27	$143.85	$160.30
United Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $121.85 / $225.53	Professional		$115.13	$121.85	$225.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $45.60 / $81.61	Professional	26	$42.21	$45.60	$81.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.81 / $79.64 / $147.40	Professional	TC	$71.81	$79.64	$147.40