Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.39 / $26.39 / $30.46	Facility	26	$26.39	$26.39	$30.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.61 / $124.59 / $192.14	Professional		$88.61	$124.59	$192.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $16.07 / $26.40	Professional	26	$11.23	$16.07	$26.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.06 / $108.51 / $166.62	Professional	TC	$75.06	$108.51	$166.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $97.23 / $210.20	Professional		$87.00	$97.23	$210.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.88 / $11.04 / $22.24	Professional	26	$9.88	$11.04	$22.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.12 / $86.19 / $180.00	Professional	TC	$77.12	$86.19	$180.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.63 / $173.63 / $356.50	Professional		$173.63	$173.63	$356.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.13 / $51.13 / $61.85	Professional	26	$51.13	$51.13	$61.85
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $294.64 / $294.64 / $294.64	Professional	TC	$294.64	$294.64	$294.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $160.12 / $184.38 / $243.71	Professional		$160.12	$184.38	$243.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.68 / $21.51 / $25.13	Professional	26	$18.68	$21.51	$25.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.44 / $162.87 / $190.30	Professional	TC	$141.44	$162.87	$190.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.04 / $32.34 / $155.00	Professional		$19.04	$32.34	$155.00
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $156.94 / $156.94 / $156.94	Facility	26	$156.94	$156.94	$156.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $180.50 / $212.35 / $243.72	Professional		$180.50	$212.35	$243.72
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $23.98 / $28.82	Professional	26	$20.38	$23.98	$28.82
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $160.12 / $188.38 / $214.89	Professional	TC	$160.12	$188.38	$214.89
United Facility/Professional Professional Modifier Low / Median / High Price $98.78 / $127.02 / $254.63	Professional		$98.78	$127.02	$254.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $12.63 / $24.51	Professional	26	$10.14	$12.63	$24.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.04 / $116.88 / $243.02	Professional	TC	$88.04	$116.88	$243.02