Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.67 / $71.78 / $71.78	Facility	26	$40.67	$71.78	$71.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.28 / $117.15 / $190.33	Professional		$96.28	$117.15	$190.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.44 / $29.66 / $60.32	Professional	26	$25.44	$29.66	$60.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.70 / $78.81 / $150.50	Professional	TC	$66.70	$78.81	$150.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.51 / $156.51 / $200.52	Professional		$106.51	$156.51	$200.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.15 / $56.19	Professional	26	$30.20	$44.15	$56.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.31 / $112.36 / $140.44	Professional	TC	$76.31	$112.36	$140.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $221.91 / $221.91 / $483.44	Professional		$221.91	$221.91	$483.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.53 / $97.53 / $134.72	Professional	26	$97.53	$97.53	$134.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.18 / $87.18 / $385.91	Professional	TC	$87.18	$87.18	$385.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.19 / $184.57 / $227.64	Professional		$169.19	$184.57	$227.64
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $48.11 / $54.98	Professional	26	$45.36	$48.11	$54.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.82 / $131.32 / $150.08	Professional	TC	$123.82	$131.32	$150.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $51.27 / $183.57	Professional		$32.34	$51.27	$183.57
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 $182.25 / $214.41 / $244.14	Professional		$182.25	$214.41	$244.14
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $48.91 / $57.54 / $69.23	Professional	26	$48.91	$57.54	$69.23
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $133.33 / $156.86 / $174.91	Professional	TC	$133.33	$156.86	$174.91
United Facility/Professional Professional Modifier Low / Median / High Price $103.47 / $115.52 / $206.19	Professional		$103.47	$115.52	$206.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.93 / $35.43 / $57.80	Professional	26	$28.93	$35.43	$57.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.54 / $83.59 / $148.91	Professional	TC	$74.54	$83.59	$148.91