Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.52 / $221.22 / $429.60	Facility		$157.52	$221.22	$429.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $137.07 / $137.07 / $137.07	Facility	26	$137.07	$137.07	$137.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $84.14 / $122.40 / $357.82	Facility	TC	$84.14	$122.40	$357.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.44 / $185.90 / $221.22	Professional		$87.44	$185.90	$221.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.28 / $115.19 / $137.07	Professional	26	$54.28	$115.19	$137.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $70.70 / $84.14	Professional	TC	$33.15	$70.70	$84.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.96 / $81.96 / $96.43	Professional		$81.96	$81.96	$96.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.32 / $50.63 / $59.56	Professional	26	$49.32	$50.63	$59.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.34 / $31.34 / $36.86	Professional	TC	$31.34	$31.34	$36.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $121.76 / $143.91 / $204.49	Facility		$121.76	$143.91	$204.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $161.19 / $167.62 / $180.73	Professional		$161.19	$167.62	$180.73
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.06 / $101.89 / $107.71	Professional	26	$96.06	$101.89	$107.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.11 / $69.06 / $73.00	Professional	TC	$65.11	$69.06	$73.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $69.59 / $179.03	Professional		$32.34	$69.59	$179.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.58 / $176.35 / $177.41	Professional		$158.58	$176.35	$177.41
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $102.59 / $104.80 / $105.91	Professional	26	$102.59	$104.80	$105.91
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $52.67 / $71.59 / $72.59	Professional	TC	$52.67	$71.59	$72.59
United Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $60.20 / $100.33	Professional		$55.55	$60.20	$100.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.34 / $39.19 / $77.00	Professional	26	$35.34	$39.19	$77.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $21.01 / $37.59	Professional	TC	$20.21	$21.01	$37.59