Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.90 / $125.90 / $128.18	Facility	26	$125.90	$125.90	$128.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.82 / $342.44 / $629.39	Professional		$293.82	$342.44	$629.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.47 / $55.15 / $105.80	Professional	26	$43.47	$55.15	$105.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $250.34 / $292.95 / $523.59	Professional	TC	$250.34	$292.95	$523.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.73 / $514.64 / $720.01	Professional		$344.73	$514.64	$720.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.08 / $83.19 / $102.89	Professional	26	$57.08	$83.19	$102.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $287.64 / $431.46 / $617.12	Professional	TC	$287.64	$431.46	$617.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $474.47 / $503.23 / $718.71	Professional		$474.47	$503.23	$718.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.45 / $83.21 / $95.10	Professional	26	$78.45	$83.21	$95.10
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $396.02 / $420.02 / $480.02	Professional	TC	$396.02	$420.02	$480.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $513.10	Professional		$32.34	$32.34	$513.10
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $949.44 / $949.44 / $949.44	Facility	26	$949.44	$949.44	$949.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $588.01 / $623.35 / $718.71	Professional		$588.01	$623.35	$718.71
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $93.35 / $100.70 / $121.32	Professional	26	$93.35	$100.70	$121.32
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $494.67 / $522.66 / $597.39	Professional	TC	$494.67	$522.66	$597.39
United Facility/Professional Professional Modifier Low / Median / High Price $273.70 / $376.44 / $648.71	Professional		$273.70	$376.44	$648.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.53 / $64.53 / $101.31	Professional	26	$42.53	$64.53	$101.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $231.17 / $305.89 / $547.40	Professional	TC	$231.17	$305.89	$547.40