Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.98 / $301.68 / $313.70	Professional		$117.98	$301.68	$313.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $58.85 / $71.18	Professional	26	$36.95	$58.85	$71.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.01 / $230.50 / $254.87	Professional	TC	$81.01	$230.50	$254.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.44 / $135.44 / $159.36	Professional		$135.44	$135.44	$159.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.33 / $31.28 / $36.81	Professional	26	$30.33	$31.28	$36.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.17 / $104.17 / $122.55	Professional	TC	$104.17	$104.17	$122.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $238.40 / $240.20 / $331.85	Facility		$238.40	$240.20	$331.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $270.33 / $275.93 / $309.38	Professional		$270.33	$275.93	$309.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.78 / $63.40 / $67.03	Professional	26	$59.78	$63.40	$67.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $216.15 / $229.25 / $242.35	Professional	TC	$216.15	$229.25	$242.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $68.33 / $300.01	Professional		$32.34	$68.33	$300.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $270.33 / $291.58 / $303.87	Professional		$270.33	$291.58	$303.87
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $63.56 / $64.98 / $65.27	Professional	26	$63.56	$64.98	$65.27
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $206.78 / $226.98 / $238.88	Professional	TC	$206.78	$226.98	$238.88
United Facility/Professional Professional Modifier Low / Median / High Price $66.78 / $105.24 / $175.40	Professional		$66.78	$105.24	$175.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $24.04 / $40.06	Professional	26	$22.87	$24.04	$40.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.91 / $81.20 / $135.34	Professional	TC	$43.91	$81.20	$135.34