Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.75 / $45.05 / $45.95	Facility	26	$39.75	$45.05	$45.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.93 / $128.18 / $234.34	Professional		$103.93	$128.18	$234.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $24.56 / $50.59	Professional	26	$16.60	$24.56	$50.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.32 / $108.74 / $191.17	Professional	TC	$87.32	$108.74	$191.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.73 / $153.52 / $190.52	Professional		$99.73	$153.52	$190.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.93 / $29.77 / $35.64	Professional	26	$20.93	$29.77	$35.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.79 / $121.97 / $150.85	Professional	TC	$77.79	$121.97	$150.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.77 / $245.77 / $272.83	Professional		$245.77	$245.77	$272.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.01 / $122.01 / $122.26	Professional	26	$122.01	$122.01	$122.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.76 / $123.76 / $123.76	Professional	TC	$123.76	$123.76	$123.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $155.31 / $178.85 / $208.97	Professional		$155.31	$178.85	$208.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.83 / $33.19 / $37.11	Professional	26	$28.83	$33.19	$37.11
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $126.49 / $145.65 / $153.32	Professional	TC	$126.49	$145.65	$153.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.72 / $32.34 / $167.47	Professional		$28.72	$32.34	$167.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $172.35 / $202.76 / $233.75	Professional		$172.35	$202.76	$233.75
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $30.86 / $36.31 / $42.69	Professional	26	$30.86	$36.31	$42.69
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $141.49 / $166.46 / $191.06	Professional	TC	$141.49	$166.46	$191.06
United Facility/Professional Professional Modifier Low / Median / High Price $92.91 / $119.47 / $195.60	Professional		$92.91	$119.47	$195.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.72 / $19.91 / $36.42	Professional	26	$18.72	$19.91	$36.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.94 / $94.40 / $186.48	Professional	TC	$62.94	$94.40	$186.48