Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.66 / $142.66 / $142.66	Facility	26	$142.66	$142.66	$142.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.19 / $710.82 / $714.64	Professional		$216.19	$710.82	$714.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.58 / $96.87 / $119.89	Professional	26	$59.58	$96.87	$119.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $156.60 / $594.75 / $613.94	Professional	TC	$156.60	$594.75	$613.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.12 / $321.12 / $377.78	Professional		$321.12	$321.12	$377.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.71 / $52.95 / $62.30	Professional	26	$50.71	$52.95	$62.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $268.16 / $268.16 / $315.48	Professional	TC	$268.16	$268.16	$315.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $620.71 / $635.07 / $695.95	Professional		$620.71	$635.07	$695.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.81 / $105.86 / $111.91	Professional	26	$99.81	$105.86	$111.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $520.91 / $552.48 / $584.04	Professional	TC	$520.91	$552.48	$584.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $114.93 / $673.08	Professional		$32.34	$114.93	$673.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $635.08 / $687.34 / $694.40	Professional		$635.08	$687.34	$694.40
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $106.49 / $107.67 / $108.32	Professional	26	$106.49	$107.67	$108.32
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $528.23 / $579.66 / $586.09	Professional	TC	$528.23	$579.66	$586.09
United Facility/Professional Professional Modifier Low / Median / High Price $122.12 / $247.07 / $487.54	Professional		$122.12	$247.07	$487.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.36 / $40.50 / $77.72	Professional	26	$37.36	$40.50	$77.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.75 / $206.57 / $344.29	Professional	TC	$84.75	$206.57	$344.29