Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.57 / $83.12 / $85.12	Facility	26	$47.57	$83.12	$85.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $198.19 / $492.71	Professional		$113.34	$198.19	$492.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $50.95 / $120.54	Professional	26	$29.75	$50.95	$120.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.52 / $67.79 / $249.00	Professional	52	$39.52	$67.79	$249.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.45 / $102.56 / $182.34	Professional	TC	$77.45	$102.56	$182.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.55 / $180.79 / $232.77	Professional		$113.55	$180.79	$232.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.78 / $51.00 / $65.80	Professional	26	$34.78	$51.00	$65.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.23 / $129.97 / $162.47	Professional	TC	$81.23	$129.97	$162.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $238.91 / $238.91 / $391.66	Professional		$238.91	$238.91	$391.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $154.82 / $154.82 / $155.49	Professional	26	$154.82	$154.82	$155.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.09 / $84.09 / $236.17	Professional	TC	$84.09	$84.09	$236.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $188.40 / $205.52 / $253.48	Professional		$188.40	$205.52	$253.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.31 / $55.48 / $63.40	Professional	26	$52.31	$55.48	$63.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $136.09 / $144.34 / $164.96	Professional	TC	$136.09	$144.34	$164.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $59.28 / $152.00	Professional		$32.34	$59.28	$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 $208.45 / $245.23 / $281.97	Professional		$208.45	$245.23	$281.97
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $56.47 / $66.44 / $80.91	Professional	26	$56.47	$66.44	$80.91
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $151.97 / $178.79 / $201.05	Professional	TC	$151.97	$178.79	$201.05
United Facility/Professional Professional Modifier Low / Median / High Price $123.88 / $131.86 / $238.76	Professional		$123.88	$131.86	$238.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $37.24 / $66.65	Professional	26	$33.70	$37.24	$66.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.43 / $95.30 / $176.39	Professional	TC	$88.43	$95.30	$176.39