Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.91 / $63.36 / $72.36	Facility	26	$55.91	$63.36	$72.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.63 / $220.82 / $365.89	Professional		$175.63	$220.82	$365.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $38.34 / $63.36	Professional	26	$28.30	$38.34	$63.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.01 / $178.73 / $259.95	Professional	TC	$139.01	$178.73	$259.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.40 / $289.86 / $459.04	Professional		$217.40	$289.86	$459.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.83 / $56.95 / $73.48	Professional	26	$39.83	$56.95	$73.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.31 / $245.52 / $296.83	Professional	TC	$173.31	$245.52	$296.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $543.11 / $543.11 / $758.72	Professional		$543.11	$543.11	$758.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $126.37 / $126.37 / $165.90	Professional	26	$126.37	$126.37	$165.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $416.74 / $416.74 / $592.82	Professional	TC	$416.74	$416.74	$592.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $299.95 / $318.13 / $363.58	Professional		$299.95	$318.13	$363.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.78 / $63.40 / $72.45	Professional	26	$59.78	$63.40	$72.45
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $240.17 / $254.73 / $291.12	Professional	TC	$240.17	$254.73	$291.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $67.09 / $256.87	Professional		$32.34	$67.09	$256.87
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 $266.11 / $283.58 / $306.32	Professional		$266.11	$283.58	$306.32
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $49.56 / $55.72 / $63.19	Professional	26	$49.56	$55.72	$63.19
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $213.44 / $227.86 / $243.13	Professional	TC	$213.44	$227.86	$243.13
United Facility/Professional Professional Modifier Low / Median / High Price $208.71 / $326.04 / $414.96	Professional		$208.71	$326.04	$414.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $46.11 / $72.18	Professional	26	$36.54	$46.11	$72.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.38 / $266.18 / $379.32	Professional	TC	$171.38	$266.18	$379.32