Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $194.10 / $194.10 / $194.10	Facility	26	$194.10	$194.10	$194.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.28 / $209.56 / $249.37	Professional		$136.28	$209.56	$249.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.05 / $163.11 / $194.10	Professional	26	$75.05	$163.11	$194.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.44 / $55.26 / $61.21	Professional	TC	$46.44	$55.26	$61.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.95 / $91.84 / $108.05	Professional		$90.95	$91.84	$108.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.23 / $71.69 / $84.34	Professional	26	$69.23	$71.69	$84.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $20.14 / $23.71	Professional	TC	$20.14	$20.14	$23.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $185.74 / $190.54 / $208.25	Professional		$185.74	$190.54	$208.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $137.69 / $146.04 / $154.38	Professional	26	$137.69	$146.04	$154.38
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.03 / $50.94 / $53.85	Professional	TC	$48.03	$50.94	$53.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $51.27 / $209.08	Professional		$32.34	$51.27	$209.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $190.54 / $198.66 / $202.00	Professional		$190.54	$198.66	$202.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $145.41 / $147.83 / $149.88	Professional	26	$145.41	$147.83	$149.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $44.32 / $52.11 / $53.24	Professional	TC	$44.32	$52.11	$53.24
United Facility/Professional Professional Modifier Low / Median / High Price $70.59 / $82.30 / $164.71	Professional		$70.59	$82.30	$164.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.81 / $54.57 / $105.03	Professional	26	$48.81	$54.57	$105.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.02 / $26.70 / $37.38	Professional	TC	$16.02	$26.70	$37.38