Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.63 / $184.68 / $184.68	Facility	26	$100.63	$184.68	$184.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.21 / $182.43 / $349.23	Professional		$147.21	$182.43	$349.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.40 / $78.62 / $176.92	Professional	26	$51.40	$78.62	$176.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.47 / $112.23 / $220.00	Professional	TC	$95.47	$112.23	$220.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.19 / $233.47 / $281.52	Professional		$158.19	$233.47	$281.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.95 / $116.69 / $137.28	Professional	26	$63.95	$116.69	$137.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.43 / $116.78 / $140.82	Professional	TC	$82.43	$116.78	$140.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $711.66 / $711.66 / $790.00	Professional		$711.66	$711.66	$790.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $216.78 / $216.78 / $557.87	Professional	26	$216.78	$216.78	$557.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $153.79 / $153.79 / $153.79	Professional	TC	$153.79	$153.79	$153.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $201.75 / $232.31 / $335.52	Professional		$201.75	$232.31	$335.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.94 / $121.66 / $133.26	Professional	26	$109.94	$121.66	$133.26
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.81 / $105.72 / $111.28	Professional	TC	$91.81	$105.72	$111.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $98.22 / $199.82	Professional		$32.34	$98.22	$199.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $267.12 / $285.64 / $335.52	Professional		$267.12	$285.64	$335.52
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $131.04 / $140.43 / $169.84	Professional	26	$131.04	$140.43	$169.84
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $136.08 / $145.22 / $165.69	Professional	TC	$136.08	$145.22	$165.69
United Facility/Professional Professional Modifier Low / Median / High Price $124.98 / $153.74 / $302.39	Professional		$124.98	$153.74	$302.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.16 / $75.79 / $121.36	Professional	26	$47.16	$75.79	$121.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.26 / $93.54 / $281.33	Professional	TC	$66.26	$93.54	$281.33