Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $137.25 / $137.25 / $173.00	Facility	26	$137.25	$137.25	$173.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.25 / $229.14 / $763.56	Professional		$131.25	$229.14	$763.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.92 / $115.34 / $507.50	Professional	26	$56.92	$115.34	$507.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.23 / $104.48 / $135.41	Professional	TC	$72.23	$104.48	$135.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.31 / $197.94 / $244.00	Professional		$154.31	$197.94	$244.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.83 / $97.82 / $117.95	Professional	26	$74.83	$97.82	$117.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.26 / $106.02 / $162.13	Professional	TC	$83.26	$106.02	$162.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $202.82 / $245.84 / $295.43	Professional		$202.82	$245.84	$295.43
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.14 / $103.02 / $117.74	Professional	26	$97.14	$103.02	$117.74
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $105.68 / $112.09 / $128.10	Professional	TC	$105.68	$112.09	$128.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $109.79 / $222.90	Professional		$32.34	$109.79	$222.90
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 $236.85 / $258.25 / $295.43	Professional		$236.85	$258.25	$295.43
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $113.67 / $123.30 / $146.66	Professional	26	$113.67	$123.30	$146.66
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $123.19 / $134.94 / $148.77	Professional	TC	$123.19	$134.94	$148.77
United Facility/Professional Professional Modifier Low / Median / High Price $137.18 / $185.50 / $316.43	Professional		$137.18	$185.50	$316.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.13 / $78.50 / $130.08	Professional	26	$66.13	$78.50	$130.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.05 / $109.76 / $187.99	Professional	TC	$71.05	$109.76	$187.99