Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.24 / $446.80 / $5,235.12	Facility		$169.24	$446.80	$5,235.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.64 / $26.64 / $26.64	Facility	26	$26.64	$26.64	$26.64
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $142.59 / $142.59 / $237.60	Facility	TC	$142.59	$142.59	$237.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $142.22 / $169.24	Professional		$79.34	$142.22	$169.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $22.39 / $49.26	Professional	26	$10.29	$22.39	$49.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.03 / $119.83 / $142.59	Professional	TC	$69.03	$119.83	$142.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.47 / $61.47 / $72.31	Professional		$61.47	$61.47	$72.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $9.84 / $11.58	Professional	26	$9.59	$9.84	$11.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.63 / $51.63 / $60.74	Professional	TC	$51.63	$51.63	$60.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $84.96 / $114.45 / $149.33	Facility		$84.96	$114.45	$149.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $126.26 / $131.29 / $147.19	Professional		$126.26	$131.29	$147.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.68 / $19.80 / $20.94	Professional	26	$18.68	$19.80	$20.94
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.61 / $119.44 / $126.26	Professional	TC	$112.61	$119.44	$126.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.16 / $32.34 / $141.72	Professional		$21.16	$32.34	$141.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.50 / $142.01 / $145.79	Professional		$114.50	$142.01	$145.79
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.84 / $20.37 / $20.49	Professional	26	$19.84	$20.37	$20.49
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $94.46 / $121.64 / $125.30	Professional	TC	$94.46	$121.64	$125.30
United Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $46.34 / $82.12	Professional		$39.40	$46.34	$82.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $7.58 / $14.82	Professional	26	$6.94	$7.58	$14.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $38.76 / $67.30	Professional	TC	$32.47	$38.76	$67.30