Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.81 / $73.81 / $92.28	Facility	26	$73.81	$73.81	$92.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.65 / $164.73 / $239.65	Professional		$139.65	$164.73	$239.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.89 / $50.45 / $66.62	Professional	26	$44.89	$50.45	$66.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.16 / $117.26 / $159.99	Professional	TC	$94.16	$117.26	$159.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.13 / $210.90 / $270.22	Professional		$146.13	$210.90	$270.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.06 / $68.94 / $88.33	Professional	26	$48.06	$68.94	$88.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.07 / $142.12 / $177.46	Professional	TC	$98.07	$142.12	$177.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $505.15 / $505.15 / $608.83	Professional		$505.15	$505.15	$608.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $163.29 / $163.29 / $185.45	Professional	26	$163.29	$163.29	$185.45
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $319.70 / $319.70 / $445.54	Professional	TC	$319.70	$319.70	$445.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $216.15 / $229.25 / $262.00	Professional		$216.15	$229.25	$262.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.31 / $72.45 / $82.80	Professional	26	$68.31	$72.45	$82.80
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.84 / $156.80 / $179.20	Professional	TC	$147.84	$156.80	$179.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $75.20 / $158.09	Professional		$32.34	$75.20	$158.09
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $446.45	Facility	26	$446.45	$446.45	$446.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $201.90 / $203.48 / $272.60	Professional		$201.90	$203.48	$272.60
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $62.76 / $63.18 / $79.65	Professional	26	$62.76	$63.18	$79.65
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $139.13 / $140.29 / $187.29	Professional	TC	$139.13	$140.29	$187.29
United Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $200.56 / $271.32	Professional		$144.00	$200.56	$271.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $66.15 / $87.03	Professional	26	$46.51	$66.15	$87.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.81 / $125.36 / $184.29	Professional	TC	$97.81	$125.36	$184.29