Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.89 / $83.89 / $83.89	Facility	26	$83.89	$83.89	$83.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.48 / $169.06 / $353.98	Professional		$118.48	$169.06	$353.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.30 / $35.70 / $81.58	Professional	26	$30.30	$35.70	$81.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.81 / $100.06 / $212.03	Professional	TC	$83.81	$100.06	$212.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.59 / $230.97 / $333.43	Professional		$125.59	$230.97	$333.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.95 / $50.48 / $64.36	Professional	26	$33.95	$50.48	$64.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.56 / $188.16 / $267.11	Professional	TC	$80.56	$188.16	$267.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.70 / $345.70 / $433.56	Professional		$345.70	$345.70	$433.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $115.17 / $115.17 / $301.64	Professional	26	$115.17	$115.17	$301.64
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.91 / $131.91 / $230.53	Professional	TC	$131.91	$131.91	$230.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $305.01 / $333.41 / $381.04	Professional		$305.01	$333.41	$381.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.23 / $54.34 / $62.10	Professional	26	$51.23	$54.34	$62.10
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.13 / $279.07 / $318.94	Professional	TC	$263.13	$279.07	$318.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $58.42 / $245.99	Professional		$32.34	$58.42	$245.99
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 $332.68 / $413.74 / $468.42	Professional		$332.68	$413.74	$468.42
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $55.90 / $65.76 / $78.62	Professional	26	$55.90	$65.76	$78.62
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $279.81 / $347.98 / $389.81	Professional	TC	$279.81	$347.98	$389.81
United Facility/Professional Professional Modifier Low / Median / High Price $137.69 / $159.88 / $278.11	Professional		$137.69	$159.88	$278.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $35.42 / $64.61	Professional	26	$34.04	$35.42	$64.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.39 / $125.59 / $236.64	Professional	TC	$85.39	$125.59	$236.64