Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.16 / $63.16 / $63.16	Facility	26	$63.16	$63.16	$63.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.28 / $177.07 / $692.00	Professional		$140.28	$177.07	$692.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.60 / $78.62 / $232.48	Professional	26	$55.60	$78.62	$232.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.03 / $113.91 / $160.61	Professional	TC	$76.03	$113.91	$160.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.65 / $210.47 / $322.70	Professional		$146.65	$210.47	$322.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.36 / $81.77 / $129.25	Professional	26	$62.36	$81.77	$129.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.54 / $111.96 / $172.55	Professional	TC	$77.54	$111.96	$172.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.27 / $75.44 / $133.33	Professional		$49.27	$75.44	$133.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $206.71 / $235.79 / $261.97	Professional		$206.71	$235.79	$261.97
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $101.62 / $112.91 / $122.62	Professional	26	$101.62	$112.91	$122.62
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $105.09 / $122.64 / $137.08	Professional	TC	$105.09	$122.64	$137.08
United Facility/Professional Professional Modifier Low / Median / High Price $120.76 / $144.84 / $261.36	Professional		$120.76	$144.84	$261.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.52 / $64.42 / $125.05	Professional	26	$48.52	$64.42	$125.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.26 / $84.68 / $185.75	Professional	TC	$66.26	$84.68	$185.75