Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.41 / $97.04 / $98.87	Facility	26	$55.41	$97.04	$98.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.54 / $154.47 / $302.91	Professional		$121.54	$154.47	$302.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $43.29 / $85.00	Professional	26	$34.46	$43.29	$85.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.07 / $106.64 / $178.03	Professional	TC	$87.07	$106.64	$178.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.57 / $200.15 / $237.70	Professional		$138.57	$200.15	$237.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.17 / $64.12 / $75.44	Professional	26	$43.17	$64.12	$75.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.40 / $136.02 / $164.03	Professional	TC	$95.40	$136.02	$164.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $321.76 / $321.76 / $486.14	Professional		$321.76	$321.76	$486.14
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $172.24 / $172.24 / $172.60	Professional	26	$172.24	$172.24	$172.60
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $149.52 / $149.52 / $313.54	Professional	TC	$149.52	$149.52	$313.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $201.22 / $231.71 / $270.73	Professional		$201.22	$231.71	$270.73
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.85 / $70.06 / $73.76	Professional	26	$60.85	$70.06	$73.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $140.37 / $161.63 / $170.14	Professional	TC	$140.37	$161.63	$170.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $68.84 / $196.47	Professional		$32.34	$68.84	$196.47
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $177.35 / $177.35 / $177.35	Facility	26	$177.35	$177.35	$177.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.93 / $257.56 / $294.60	Professional		$218.93	$257.56	$294.60
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $66.38 / $78.09 / $93.55	Professional	26	$66.38	$78.09	$93.55
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $152.55 / $179.47 / $201.05	Professional	TC	$152.55	$179.47	$201.05
United Facility/Professional Professional Modifier Low / Median / High Price $140.78 / $150.06 / $257.04	Professional		$140.78	$150.06	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.56 / $50.23 / $79.66	Professional	26	$41.56	$50.23	$79.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.22 / $104.37 / $178.17	Professional	TC	$99.22	$104.37	$178.17