Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.45 / $38.94 / $44.38	Facility	26	$38.45	$38.94	$44.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.93 / $135.53 / $220.23	Professional		$109.93	$135.53	$220.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $23.14 / $34.72	Professional	26	$14.49	$23.14	$34.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.66 / $112.49 / $172.15	Professional	TC	$91.66	$112.49	$172.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.03 / $189.13 / $307.95	Professional		$140.03	$189.13	$307.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.72 / $34.14 / $45.53	Professional	26	$21.72	$34.14	$45.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.72 / $159.68 / $247.58	Professional	TC	$112.72	$159.68	$247.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $351.85 / $351.85 / $424.07	Professional		$351.85	$351.85	$424.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.81 / $73.81 / $76.84	Professional	26	$73.81	$73.81	$76.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.00 / $275.00 / $350.25	Professional	TC	$275.00	$275.00	$350.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $195.34 / $207.18 / $236.78	Professional		$195.34	$207.18	$236.78
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.29 / $38.50 / $44.00	Professional	26	$36.29	$38.50	$44.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.04 / $168.68 / $192.78	Professional	TC	$159.04	$168.68	$192.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $40.72 / $210.83	Professional		$32.34	$40.72	$210.83
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 $172.79 / $184.57 / $197.99	Professional		$172.79	$184.57	$197.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $29.68 / $34.33 / $38.20	Professional	26	$29.68	$34.33	$38.20
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $140.44 / $150.25 / $159.79	Professional	TC	$140.44	$150.25	$159.79
United Facility/Professional Professional Modifier Low / Median / High Price $138.32 / $222.76 / $287.11	Professional		$138.32	$222.76	$287.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.21 / $25.26 / $42.49	Professional	26	$20.21	$25.26	$42.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.72 / $187.81 / $252.00	Professional	TC	$111.72	$187.81	$252.00