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 / $83.81	Facility	26	$47.57	$83.12	$83.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.65 / $132.21 / $521.24	Professional		$73.65	$132.21	$521.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $49.72 / $124.15	Professional	26	$29.75	$49.72	$124.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.76 / $97.23 / $173.58	Professional	TC	$66.76	$97.23	$173.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $161.11 / $217.09	Professional		$100.69	$161.11	$217.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.45 / $50.48 / $66.23	Professional	26	$34.45	$50.48	$66.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.66 / $115.68 / $157.93	Professional	TC	$70.66	$115.68	$157.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $283.55 / $283.55 / $370.02	Professional		$283.55	$283.55	$370.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $156.87 / $156.87 / $157.55	Professional	26	$156.87	$156.87	$157.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $126.68 / $126.68 / $212.47	Professional	TC	$126.68	$126.68	$212.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $167.59 / $187.90 / $225.49	Professional		$167.59	$187.90	$225.49
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.78 / $54.92 / $62.76	Professional	26	$51.78	$54.92	$62.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $115.81 / $126.34 / $145.36	Professional	TC	$115.81	$126.34	$145.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $84.20 / $182.42	Professional		$32.34	$84.20	$182.42
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 $183.99 / $216.46 / $248.90	Professional		$183.99	$216.46	$248.90
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $55.90 / $65.76 / $80.14	Professional	26	$55.90	$65.76	$80.14
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $128.10 / $150.69 / $168.76	Professional	TC	$128.10	$150.69	$168.76
United Facility/Professional Professional Modifier Low / Median / High Price $111.52 / $127.64 / $236.25	Professional		$111.52	$127.64	$236.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $42.01 / $70.80	Professional	26	$33.36	$42.01	$70.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.51 / $94.28 / $174.50	Professional	TC	$76.51	$94.28	$174.50