Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.54 / $119.98 / $121.86	Facility	26	$68.54	$119.98	$121.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.33 / $195.76 / $321.45	Professional		$154.33	$195.76	$321.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $52.10 / $100.83	Professional	26	$42.89	$52.10	$100.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.43 / $136.50 / $220.63	Professional	TC	$111.43	$136.50	$220.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.66 / $253.28 / $301.48	Professional		$175.66	$253.28	$301.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.63 / $79.28 / $93.27	Professional	26	$53.63	$79.28	$93.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.03 / $174.00 / $209.82	Professional	TC	$122.03	$174.00	$209.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $358.96 / $358.96 / $617.13	Professional		$358.96	$358.96	$617.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $212.23 / $212.23 / $212.67	Professional	26	$212.23	$212.23	$212.67
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $146.72 / $146.72 / $404.46	Professional	TC	$146.72	$146.72	$404.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $253.52 / $291.94 / $341.10	Professional		$253.52	$291.94	$341.10
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.73 / $86.05 / $90.58	Professional	26	$74.73	$86.05	$90.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $178.79 / $205.88 / $216.72	Professional	TC	$178.79	$205.88	$216.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $76.16 / $276.16	Professional		$32.34	$76.16	$276.16
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $226.77 / $226.77 / $226.77	Facility	26	$226.77	$226.77	$226.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $277.14 / $326.06 / $371.70	Professional		$277.14	$326.06	$371.70
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $81.52 / $95.90 / $115.29	Professional	26	$81.52	$95.90	$115.29
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $195.64 / $230.16 / $256.41	Professional	TC	$195.64	$230.16	$256.41
United Facility/Professional Professional Modifier Low / Median / High Price $178.60 / $188.97 / $300.51	Professional		$178.60	$188.97	$300.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.67 / $56.38 / $96.57	Professional	26	$51.67	$56.38	$96.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.92 / $137.50 / $227.12	Professional	TC	$126.92	$137.50	$227.12