Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.65 / $136.02 / $200.00	Professional		$84.65	$136.02	$200.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.72 / $77.27 / $108.41	Professional	26	$56.72	$77.27	$108.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $48.10 / $72.16	Professional	TC	$26.89	$48.10	$72.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.89 / $141.11 / $182.59	Professional		$84.89	$141.11	$182.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.59 / $85.95 / $112.05	Professional	26	$58.59	$85.95	$112.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.03 / $48.94 / $68.88	Professional	TC	$24.03	$48.94	$68.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.70 / $162.58 / $186.96	Professional		$104.70	$162.58	$186.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.60 / $87.53 / $106.10	Professional	26	$62.60	$87.53	$106.10
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.71 / $66.70 / $80.86	Professional	TC	$47.71	$66.70	$80.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $36.57 / $153.27	Professional		$32.34	$36.57	$153.27
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 $123.05 / $144.77 / $187.47	Professional		$123.05	$144.77	$187.47
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $68.93 / $81.09 / $115.27	Professional	26	$68.93	$81.09	$115.27
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $54.13 / $63.68 / $70.06	Professional	TC	$54.13	$63.68	$70.06
United Facility/Professional Professional Modifier Low / Median / High Price $87.40 / $117.11 / $158.60	Professional		$87.40	$117.11	$158.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.69 / $78.03 / $105.83	Professional	26	$59.69	$78.03	$105.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.13 / $35.72 / $55.45	Professional	TC	$27.13	$35.72	$55.45