Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.56 / $160.09 / $275.00	Professional		$133.56	$160.09	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.18 / $52.86 / $93.79	Professional	26	$43.18	$52.86	$93.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.37 / $108.85 / $200.77	Professional	TC	$90.37	$108.85	$200.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.59 / $171.00 / $220.48	Professional		$123.59	$171.00	$220.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.57 / $65.20 / $80.78	Professional	26	$48.57	$65.20	$80.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.83 / $107.46 / $137.68	Professional	TC	$73.83	$107.46	$137.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $291.99 / $291.99 / $315.11	Professional		$291.99	$291.99	$315.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $94.32 / $94.32 / $140.34	Professional	26	$94.32	$94.32	$140.34
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.65 / $151.65 / $220.79	Professional	TC	$151.65	$151.65	$220.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $221.36 / $267.19 / $305.36	Professional		$221.36	$267.19	$305.36
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $70.75 / $80.86	Professional	26	$66.70	$70.75	$80.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $185.20 / $196.42 / $224.48	Professional	TC	$185.20	$196.42	$224.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $75.66 / $246.00	Professional		$32.34	$75.66	$246.00
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $513.03 / $513.03 / $513.03	Facility	26	$513.03	$513.03	$513.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $180.45 / $218.18 / $221.36	Professional		$180.45	$218.18	$221.36
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $52.70 / $55.55 / $70.33	Professional	26	$52.70	$55.55	$70.33
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $125.74 / $154.28 / $162.62	Professional	TC	$125.74	$154.28	$162.62
United Facility/Professional Professional Modifier Low / Median / High Price $105.74 / $161.15 / $238.95	Professional		$105.74	$161.15	$238.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.03 / $61.00 / $82.97	Professional	26	$44.03	$61.00	$82.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.71 / $95.75 / $150.63	Professional	TC	$61.71	$95.75	$150.63