Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.19 / $475.20 / $737.44	Facility		$124.19	$475.20	$737.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.36 / $76.59 / $77.23	Facility	26	$43.36	$76.59	$77.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.42 / $162.00 / $379.48	Professional		$59.42	$162.00	$379.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $33.88 / $94.82	Professional	26	$28.51	$33.88	$94.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $64.15 / $187.42	Professional	TC	$22.11	$64.15	$187.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.75 / $91.44 / $184.02	Professional		$60.75	$91.44	$184.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.09 / $47.64 / $61.04	Professional	26	$32.09	$47.64	$61.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.66 / $41.49 / $113.22	Professional	TC	$28.66	$41.49	$113.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $333.90 / $333.90 / $446.44	Professional		$333.90	$333.90	$446.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $149.69 / $149.69 / $317.83	Professional	26	$149.69	$149.69	$317.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $16.05 / $296.75	Professional	TC	$16.05	$16.05	$296.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $52.80 / $148.10 / $415.25	Facility		$52.80	$148.10	$415.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $94.46 / $105.91 / $138.00	Professional		$94.46	$105.91	$138.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.03 / $50.94 / $58.22	Professional	26	$48.03	$50.94	$58.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.43 / $50.65 / $105.91	Professional	TC	$46.43	$50.65	$105.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $48.06 / $104.13	Professional		$32.34	$48.06	$104.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $101.31 / $119.19 / $138.00	Professional		$101.31	$119.19	$138.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $51.82 / $60.97 / $73.81	Professional	26	$51.82	$60.97	$73.81
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $49.30 / $58.23 / $64.19	Professional	TC	$49.30	$58.23	$64.19
United Facility/Professional Professional Modifier Low / Median / High Price $58.47 / $110.17 / $382.41	Professional		$58.47	$110.17	$382.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.47 / $34.20 / $64.95	Professional	26	$32.47	$34.20	$64.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.99 / $56.63 / $321.29	Professional	TC	$25.99	$56.63	$321.29