Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.60 / $992.11 / $1,349.96	Facility		$229.60	$992.11	$1,349.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.54 / $195.00 / $211.57	Facility	26	$40.54	$195.00	$211.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $172.36 / $532.38 / $549.14	Facility	TC	$172.36	$532.38	$549.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.40 / $222.00 / $912.00	Professional		$154.40	$222.00	$912.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.48 / $40.54 / $156.00	Professional	26	$30.48	$40.54	$156.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.19 / $178.73 / $427.06	Professional	TC	$145.19	$178.73	$427.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.74 / $736.90 / $845.81	Facility		$253.74	$736.90	$845.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.80 / $285.12 / $378.40	Professional		$215.80	$285.12	$378.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.11 / $46.63 / $69.09	Professional	26	$38.11	$46.63	$69.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.93 / $234.66 / $309.04	Professional	TC	$176.93	$234.66	$309.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $150.89 / $200.77	Professional		$32.34	$150.89	$200.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $378.22 / $471.61 / $677.06	Facility		$378.22	$471.61	$677.06
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $418.84 / $418.84 / $418.84	Facility	26	$418.84	$418.84	$418.84
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $418.84 / $418.84 / $418.84	Facility	TC	$418.84	$418.84	$418.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $214.59 / $266.42 / $343.52	Professional		$214.59	$266.42	$343.52
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $49.07 / $64.66	Professional	26	$37.11	$49.07	$64.66
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $177.48 / $219.82 / $278.86	Professional	TC	$177.48	$219.82	$278.86
United Facility/Professional Professional Modifier Low / Median / High Price $178.56 / $246.40 / $380.00	Professional		$178.56	$246.40	$380.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $42.30 / $59.14	Professional	26	$31.62	$42.30	$59.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.41 / $209.23 / $319.69	Professional	TC	$140.41	$209.23	$319.69