Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.65 / $115.65 / $116.62	Facility	26	$115.65	$115.65	$116.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.14 / $235.98 / $942.49	Professional		$192.14	$235.98	$942.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.70 / $88.25 / $347.00	Professional	26	$68.70	$88.25	$347.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.17 / $149.44 / $204.78	Professional	TC	$118.17	$149.44	$204.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.34 / $292.33 / $418.35	Professional		$193.34	$292.33	$418.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $108.13 / $138.54	Professional	26	$75.86	$108.13	$138.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.93 / $187.25 / $245.93	Professional	TC	$119.93	$187.25	$245.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $610.27 / $610.27 / $735.52	Professional		$610.27	$610.27	$735.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $884.32 / $884.32 / $984.28	Professional	26	$884.32	$884.32	$984.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $884.32 / $884.32 / $984.28	Professional	TC	$884.32	$884.32	$984.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $291.95 / $309.64 / $353.88	Professional		$291.95	$309.64	$353.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.81 / $117.61 / $130.68	Professional	26	$107.81	$117.61	$130.68
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $184.14 / $195.30 / $223.20	Professional	TC	$184.14	$195.30	$223.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $110.43 / $320.05	Professional		$32.34	$110.43	$320.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $936.81 / $936.81 / $936.81	Facility	26	$936.81	$936.81	$936.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $273.41 / $276.61 / $318.06	Professional		$273.41	$276.61	$318.06
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $98.76 / $100.50 / $129.21	Professional	26	$98.76	$100.50	$129.21
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $174.65 / $176.12 / $208.98	Professional	TC	$174.65	$176.12	$208.98
United Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $284.08 / $372.10	Professional		$200.00	$284.08	$372.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.55 / $105.00 / $137.36	Professional	26	$76.55	$105.00	$137.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.92 / $178.20 / $243.23	Professional	TC	$126.92	$178.20	$243.23