Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.17 / $39.17 / $39.17	Facility	26	$39.17	$39.17	$39.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.63 / $185.77 / $221.66	Professional		$128.63	$185.77	$221.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $22.95 / $37.52	Professional	26	$18.76	$22.95	$37.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.29 / $162.12 / $195.01	Professional	TC	$109.29	$162.12	$195.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.94 / $193.94 / $317.43	Professional		$140.94	$193.94	$317.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.02 / $35.51 / $45.82	Professional	26	$25.02	$35.51	$45.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.45 / $160.72 / $203.21	Professional	TC	$113.45	$160.72	$203.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $325.57 / $325.57 / $392.39	Professional		$325.57	$325.57	$392.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.18 / $75.18 / $77.23	Professional	26	$75.18	$75.18	$77.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $250.39 / $250.39 / $315.16	Professional	TC	$250.39	$250.39	$315.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $196.42 / $208.32 / $238.08	Professional		$196.42	$208.32	$238.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.83 / $39.06 / $44.64	Professional	26	$36.83	$39.06	$44.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.59 / $183.77 / $214.72	Professional	TC	$159.59	$183.77	$214.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $41.01 / $211.69	Professional		$32.34	$41.01	$211.69
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $174.17 / $186.07 / $198.24	Professional		$174.17	$186.07	$198.24
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $32.97 / $34.83 / $38.97	Professional	26	$32.97	$34.83	$38.97
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $140.91 / $151.24 / $159.26	Professional	TC	$140.91	$151.24	$159.26
United Facility/Professional Professional Modifier Low / Median / High Price $138.32 / $220.50 / $304.50	Professional		$138.32	$220.50	$304.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $31.20 / $46.80	Professional	26	$24.78	$31.20	$46.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.96 / $186.40 / $279.61	Professional	TC	$110.96	$186.40	$279.61