Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.56 / $113.56 / $143.13	Facility	26	$113.56	$113.56	$143.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.60 / $157.44 / $205.64	Professional		$95.60	$157.44	$205.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.42 / $79.50 / $113.56	Professional	26	$43.42	$79.50	$113.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.61 / $68.05 / $77.95	Professional	TC	$48.61	$68.05	$77.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.21 / $148.62 / $179.22	Professional		$115.21	$148.62	$179.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.00 / $81.27 / $93.16	Professional	26	$61.00	$81.27	$93.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.39 / $71.31 / $81.22	Professional	TC	$53.39	$71.31	$81.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $152.63 / $161.88 / $241.08	Professional		$152.63	$161.88	$241.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.59 / $85.47 / $97.68	Professional	26	$80.59	$85.47	$97.68
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.06 / $76.42 / $87.34	Professional	TC	$72.06	$76.42	$87.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.23 / $167.90	Professional		$32.34	$72.23	$167.90
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $657.04 / $657.04 / $657.04	Facility	26	$657.04	$657.04	$657.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $177.80 / $193.86 / $222.08	Professional		$177.80	$193.86	$222.08
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $94.62 / $102.07 / $121.75	Professional	26	$94.62	$102.07	$121.75
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $83.19 / $91.79 / $100.33	Professional	TC	$83.19	$91.79	$100.33
United Facility/Professional Professional Modifier Low / Median / High Price $101.84 / $122.96 / $210.97	Professional		$101.84	$122.96	$210.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.10 / $62.21 / $100.01	Professional	26	$55.10	$62.21	$100.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.74 / $64.67 / $95.76	Professional	TC	$46.74	$64.67	$95.76