Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.57 / $62.57 / $62.57	Facility	26	$62.57	$62.57	$62.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.95 / $209.15 / $334.81	Professional		$182.95	$209.15	$334.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.46 / $36.65 / $62.57	Professional	26	$21.46	$36.65	$62.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.29 / $178.73 / $275.93	Professional	TC	$146.29	$178.73	$275.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.78 / $298.37 / $459.89	Professional		$223.78	$298.37	$459.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.69 / $55.31 / $73.73	Professional	26	$33.69	$55.31	$73.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.53 / $251.53 / $361.52	Professional	TC	$179.53	$251.53	$361.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $531.42 / $531.42 / $640.50	Professional		$531.42	$531.42	$640.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.65 / $91.65 / $115.28	Professional	26	$91.65	$91.65	$115.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $416.15 / $416.15 / $548.85	Professional	TC	$416.15	$416.15	$548.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $313.48 / $333.50 / $377.86	Professional		$313.48	$333.50	$377.86
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 $255.12 / $278.32 / $309.24	Professional	TC	$255.12	$278.32	$309.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $66.81 / $339.46	Professional		$32.34	$66.81	$339.46
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 $273.04 / $295.52 / $313.48	Professional		$273.04	$295.52	$313.48
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.91 / $55.72 / $62.39	Professional	26	$47.91	$55.72	$62.39
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $220.84 / $239.80 / $251.09	Professional	TC	$220.84	$239.80	$251.09
United Facility/Professional Professional Modifier Low / Median / High Price $220.92 / $333.52 / $420.84	Professional		$220.92	$333.52	$420.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.49 / $41.14 / $69.42	Professional	26	$29.49	$41.14	$69.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.22 / $281.39 / $406.79	Professional	TC	$178.22	$281.39	$406.79