Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.30 / $62.67 / $69.44	Facility	26	$55.30	$62.67	$69.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.28 / $89.00 / $181.77	Professional		$61.28	$89.00	$181.77
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $113.88 / $113.88 / $113.88	Professional	25	$113.88	$113.88	$113.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.70 / $47.43 / $172.11	Professional	26	$34.70	$47.43	$172.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $42.61 / $71.59	Professional	TC	$22.57	$42.61	$71.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.74 / $111.56 / $138.33	Professional		$61.74	$111.56	$138.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.21 / $57.72 / $77.20	Professional	26	$39.21	$57.72	$77.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.02 / $47.56 / $68.30	Professional	TC	$22.02	$47.56	$68.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $84.04 / $130.44 / $150.08	Professional		$84.04	$130.44	$150.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.22 / $57.63 / $69.86	Professional	26	$41.22	$57.63	$69.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.33 / $66.18 / $80.22	Professional	TC	$47.33	$66.18	$80.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $33.72 / $122.50	Professional		$32.34	$33.72	$122.50
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $72.06 / $72.06 / $72.06	Facility	26	$72.06	$72.06	$72.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $99.37 / $116.91 / $143.55	Professional		$99.37	$116.91	$143.55
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $45.67 / $53.73 / $76.38	Professional	26	$45.67	$53.73	$76.38
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.18 / $69.54	Professional	TC	$53.70	$63.18	$69.54
United Facility/Professional Professional Modifier Low / Median / High Price $62.32 / $88.75 / $129.66	Professional		$62.32	$88.75	$129.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $52.32 / $71.83	Professional	26	$39.90	$52.32	$71.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.60 / $33.60 / $51.14	Professional	TC	$24.60	$33.60	$51.14