Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.95 / $119.95 / $119.95	Facility	26	$119.95	$119.95	$119.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $66.29 / $120.53	Professional		$60.27	$66.29	$120.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.32 / $48.75 / $87.47	Professional	26	$40.32	$48.75	$87.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $20.87 / $33.07	Professional	TC	$17.57	$20.87	$33.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.38 / $103.30 / $118.42	Professional		$79.38	$103.30	$118.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $74.44 / $85.34	Professional	26	$55.00	$74.44	$85.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.06 / $28.86 / $34.50	Professional	TC	$23.06	$28.86	$34.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $105.14 / $125.61 / $154.44	Professional		$105.14	$125.61	$154.44
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.18 / $78.68 / $89.92	Professional	26	$74.18	$78.68	$89.92
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.95 / $32.83 / $37.52	Professional	TC	$30.95	$32.83	$37.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.94 / $116.47	Professional		$32.34	$32.94	$116.47
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $246.13 / $246.13 / $246.13	Facility	26	$246.13	$246.13	$246.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $122.56 / $133.58 / $154.44	Professional		$122.56	$133.58	$154.44
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $86.36 / $93.85 / $111.02	Professional	26	$86.36	$93.85	$111.02
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $36.20 / $39.72 / $43.43	Professional	TC	$36.20	$39.72	$43.43
United Facility/Professional Professional Modifier Low / Median / High Price $69.91 / $79.68 / $132.86	Professional		$69.91	$79.68	$132.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.78 / $56.84 / $92.94	Professional	26	$49.78	$56.84	$92.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.13 / $23.90 / $40.86	Professional	TC	$20.13	$23.90	$40.86