Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.79 / $60.79 / $60.79	Facility	26	$60.79	$60.79	$60.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.14 / $120.61 / $143.52	Professional		$64.14	$120.61	$143.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.94 / $51.09 / $60.79	Professional	26	$24.94	$51.09	$60.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.20 / $69.52 / $99.38	Professional	TC	$39.20	$69.52	$99.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.97 / $51.97 / $61.14	Professional		$51.97	$51.97	$61.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.76 / $22.45 / $26.42	Professional	26	$21.76	$22.45	$26.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.52 / $29.52 / $34.72	Professional	TC	$29.52	$29.52	$34.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $112.12 / $128.09 / $143.62	Professional		$112.12	$128.09	$143.62
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.23 / $43.23 / $48.47	Professional	26	$43.23	$43.23	$48.47
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.86 / $90.00 / $95.15	Professional	TC	$84.86	$90.00	$95.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $139.85	Professional		$32.34	$32.34	$139.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.12 / $119.89 / $132.91	Professional		$112.12	$119.89	$132.91
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $45.23 / $46.84 / $47.52	Professional	26	$45.23	$46.84	$47.52
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $66.88 / $73.91 / $86.07	Professional	TC	$66.88	$73.91	$86.07
United Facility/Professional Professional Modifier Low / Median / High Price $40.64 / $41.79 / $73.75	Professional		$40.64	$41.79	$73.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $17.54 / $35.21	Professional	26	$16.34	$17.54	$35.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $24.30 / $55.42	Professional	TC	$24.25	$24.30	$55.42