Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.99 / $193.25 / $720.92	Facility		$142.99	$193.25	$720.92
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.62 / $26.62 / $26.62	Facility	26	$26.62	$26.62	$26.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.81 / $193.25 / $681.00	Professional		$111.81	$193.25	$681.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.91 / $23.42 / $48.83	Professional	26	$19.91	$23.42	$48.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $59.33 / $92.28 / $357.34	Professional	52	$59.33	$92.28	$357.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.52 / $164.30 / $271.43	Professional	TC	$100.52	$164.30	$271.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.24 / $476.97 / $547.46	Facility		$164.24	$476.97	$547.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.66 / $193.25 / $264.07	Professional		$148.66	$193.25	$264.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.98 / $30.43 / $44.70	Professional	26	$24.98	$30.43	$44.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.98 / $164.18 / $219.41	Professional	TC	$122.98	$164.18	$219.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.90 / $86.94 / $116.44	Professional		$67.90	$86.94	$116.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $230.97 / $296.17 / $431.61	Facility		$230.97	$296.17	$431.61
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $253.98 / $253.98 / $253.98	Facility	26	$253.98	$253.98	$253.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $149.56 / $192.71 / $241.00	Professional		$149.56	$192.71	$241.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $24.48 / $31.84 / $41.18	Professional	26	$24.48	$31.84	$41.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $125.08 / $159.78 / $199.80	Professional	TC	$125.08	$159.78	$199.80
United Facility/Professional Professional Modifier Low / Median / High Price $121.55 / $171.02 / $251.50	Professional		$121.55	$171.02	$251.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.47 / $25.56 / $38.02	Professional	26	$20.47	$25.56	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.92 / $145.21 / $218.00	Professional	TC	$98.92	$145.21	$218.00