Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.79 / $111.64 / $184.08	Professional		$90.79	$111.64	$184.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.67 / $32.19 / $36.49	Professional	26	$24.67	$32.19	$36.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.65 / $83.10 / $151.91	Professional	TC	$61.65	$83.10	$151.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.14 / $241.80 / $397.36	Professional		$164.14	$241.80	$397.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.98 / $40.79 / $54.03	Professional	26	$28.98	$40.79	$54.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.94 / $203.93 / $311.70	Professional	TC	$137.94	$203.93	$311.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $373.75 / $373.75 / $450.46	Professional		$373.75	$373.75	$450.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.31 / $60.31 / $68.50	Professional	26	$60.31	$60.31	$68.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $305.25 / $305.25 / $390.15	Professional	TC	$305.25	$305.25	$390.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $257.77 / $273.39 / $312.45	Professional		$257.77	$273.39	$312.45
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.58 / $60.01 / $68.58	Professional	26	$56.58	$60.01	$68.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $201.22 / $213.41 / $243.90	Professional	TC	$201.22	$213.41	$243.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $63.82 / $251.69	Professional		$32.34	$63.82	$251.69
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 $222.68 / $238.30 / $254.79	Professional		$222.68	$238.30	$254.79
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $34.19 / $36.32 / $41.39	Professional	26	$34.19	$36.32	$41.39
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $186.35 / $201.99 / $213.41	Professional	TC	$186.35	$201.99	$213.41
United Facility/Professional Professional Modifier Low / Median / High Price $173.93 / $268.80 / $371.20	Professional		$173.93	$268.80	$371.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.07 / $40.94 / $52.77	Professional	26	$27.07	$40.94	$52.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $145.91 / $230.58 / $307.44	Professional	TC	$145.91	$230.58	$307.44