Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $136.46 / $136.46 / $136.46	Facility	26	$136.46	$136.46	$136.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.59 / $170.59 / $203.00	Professional		$90.59	$170.59	$203.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.23 / $114.68 / $136.46	Professional	26	$54.23	$114.68	$136.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.35 / $55.91 / $66.53	Professional	TC	$36.35	$55.91	$66.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $75.76 / $89.13	Professional		$75.17	$75.76	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.04 / $50.66 / $59.60	Professional	26	$49.04	$50.66	$59.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.09 / $25.09 / $29.52	Professional	TC	$25.09	$25.09	$29.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $145.71 / $153.35 / $163.37	Professional		$145.71	$153.35	$163.37
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.54 / $101.33 / $107.12	Professional	26	$95.54	$101.33	$107.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.18 / $53.22 / $56.26	Professional	TC	$50.18	$53.22	$56.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $53.55 / $162.47	Professional		$32.34	$53.55	$162.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $145.99 / $160.43 / $160.43	Professional		$145.99	$160.43	$160.43
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $102.65 / $104.22 / $105.91	Professional	26	$102.65	$104.22	$105.91
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $40.07 / $55.87 / $56.21	Professional	TC	$40.07	$55.87	$56.21
United Facility/Professional Professional Modifier Low / Median / High Price $55.22 / $58.21 / $120.09	Professional		$55.22	$58.21	$120.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.95 / $39.19 / $65.31	Professional	26	$35.95	$39.19	$65.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $22.26 / $37.39	Professional	TC	$16.03	$22.26	$37.39