Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.24 / $66.61 / $66.61	Facility	26	$38.24	$66.61	$66.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.43 / $113.31 / $200.53	Professional		$92.43	$113.31	$200.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.17 / $27.03 / $55.98	Professional	26	$23.17	$27.03	$55.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.26 / $86.27 / $144.55	Professional	TC	$69.26	$86.27	$144.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.57 / $152.99 / $184.49	Professional		$98.57	$152.99	$184.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.07 / $44.02 / $51.78	Professional	26	$29.07	$44.02	$51.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.50 / $108.89 / $128.19	Professional	TC	$69.50	$108.89	$128.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $286.27 / $286.27 / $317.80	Professional		$286.27	$286.27	$317.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $130.10 / $130.10 / $168.92	Professional	26	$130.10	$130.10	$168.92
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $148.88 / $148.88 / $156.18	Professional	TC	$148.88	$148.88	$156.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.52 / $182.53 / $213.28	Professional		$158.52	$182.53	$213.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.63 / $47.94 / $56.01	Professional	26	$41.63	$47.94	$56.01
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $116.89 / $134.60 / $144.34	Professional	TC	$116.89	$134.60	$144.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $47.01 / $154.25	Professional		$32.34	$47.01	$154.25
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $174.10 / $204.82 / $233.38	Professional		$174.10	$204.82	$233.38
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $45.42 / $53.43 / $64.23	Professional	26	$45.42	$53.43	$64.23
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $128.68 / $151.38 / $169.14	Professional	TC	$128.68	$151.38	$169.14
United Facility/Professional Professional Modifier Low / Median / High Price $96.72 / $105.86 / $195.94	Professional		$96.72	$105.86	$195.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.55 / $28.59 / $54.69	Professional	26	$26.55	$28.59	$54.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.20 / $79.31 / $135.13	Professional	TC	$68.20	$79.31	$135.13