Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.50 / $97.50 / $101.11	Facility	26	$97.50	$97.50	$101.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.34 / $164.35 / $318.54	Professional		$145.34	$164.35	$318.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.51 / $49.68 / $81.25	Professional	26	$44.51	$49.68	$81.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $112.25 / $237.29	Professional	TC	$96.82	$112.25	$237.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $141.30 / $302.55	Professional		$81.81	$141.30	$302.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $35.71 / $78.44	Professional	26	$28.25	$35.71	$78.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.79 / $105.59 / $221.62	Professional	TC	$53.79	$105.59	$221.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $278.60 / $295.49 / $337.70	Professional		$278.60	$295.49	$337.70
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.18 / $70.19 / $80.22	Professional	26	$66.18	$70.19	$80.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $212.42 / $225.30 / $257.48	Professional	TC	$212.42	$225.30	$257.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $75.84 / $303.23	Professional		$32.34	$75.84	$303.23
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $289.37 / $289.37 / $289.37	Facility	26	$289.37	$289.37	$289.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $290.41 / $311.49 / $313.12	Professional		$290.41	$311.49	$313.12
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $71.69 / $72.59 / $73.84	Professional	26	$71.69	$72.59	$73.84
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $218.12 / $238.88 / $240.37	Professional	TC	$218.12	$238.88	$240.37
United Facility/Professional Professional Modifier Low / Median / High Price $99.46 / $110.44 / $260.58	Professional		$99.46	$110.44	$260.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $33.90 / $59.29	Professional	26	$27.50	$33.90	$59.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.56 / $82.94 / $167.73	Professional	TC	$65.56	$82.94	$167.73