Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.40 / $118.30 / $237.70	Facility		$98.40	$118.30	$237.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.48 / $58.48 / $58.48	Facility	26	$58.48	$58.48	$58.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $179.21 / $306.95 / $420.00	Facility	TC	$179.21	$306.95	$420.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.60 / $199.75 / $237.70	Professional		$107.60	$199.75	$237.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.64 / $49.15 / $58.48	Professional	26	$23.64	$49.15	$58.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.94 / $150.60 / $179.21	Professional	TC	$83.94	$150.60	$179.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.97 / $85.97 / $101.14	Professional		$85.97	$85.97	$101.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.93 / $21.86 / $25.72	Professional	26	$20.93	$21.86	$25.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.11 / $64.11 / $75.42	Professional	TC	$64.11	$64.11	$75.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $118.06 / $156.75 / $209.74	Facility		$118.06	$156.75	$209.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $178.79 / $180.75 / $200.47	Professional		$178.79	$180.75	$200.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.10 / $43.59 / $46.08	Professional	26	$41.10	$43.59	$46.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $137.69 / $146.04 / $154.38	Professional	TC	$137.69	$146.04	$154.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $147.21	Professional		$32.34	$32.34	$147.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.01 / $194.97 / $197.90	Professional		$158.01	$194.97	$197.90
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $44.04 / $44.81 / $45.08	Professional	26	$44.04	$44.81	$45.08
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $113.36 / $150.16 / $152.82	Professional	TC	$113.36	$150.16	$152.82
United Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $64.31 / $116.94	Professional		$56.16	$64.31	$116.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.52 / $16.67 / $33.11	Professional	26	$15.52	$16.67	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.64 / $47.64 / $83.82	Professional	TC	$40.64	$47.64	$83.82