Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.39 / $63.42 / $71.86	Facility	26	$62.39	$63.42	$71.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.13 / $224.01 / $401.55	Professional		$163.13	$224.01	$401.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.44 / $58.00 / $113.40	Professional	26	$42.44	$58.00	$113.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.02 / $166.96 / $204.06	Professional	TC	$116.02	$166.96	$204.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.58 / $254.42 / $403.09	Professional		$178.58	$254.42	$403.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.10 / $63.01 / $99.84	Professional	26	$42.10	$63.01	$99.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.12 / $183.67 / $263.77	Professional	TC	$135.12	$183.67	$263.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $365.57 / $365.57 / $516.83	Professional		$365.57	$365.57	$516.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $190.04 / $190.04 / $193.77	Professional	26	$190.04	$190.04	$193.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $171.80 / $171.80 / $326.79	Professional	TC	$171.80	$171.80	$326.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $252.45 / $267.75 / $306.00	Professional		$252.45	$267.75	$306.00
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 $192.67 / $204.35 / $233.54	Professional	TC	$192.67	$204.35	$233.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $85.37 / $255.24	Professional		$32.34	$85.37	$255.24
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 $219.45 / $236.81 / $255.64	Professional		$219.45	$236.81	$255.64
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $51.74 / $55.72 / $63.47	Professional	26	$51.74	$55.72	$63.47
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $167.71 / $181.09 / $192.17	Professional	TC	$167.71	$181.09	$192.17
United Facility/Professional Professional Modifier Low / Median / High Price $176.32 / $283.16 / $358.96	Professional		$176.32	$283.16	$358.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.94 / $75.70 / $98.59	Professional	26	$42.94	$75.70	$98.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.29 / $210.14 / $261.51	Professional	TC	$133.29	$210.14	$261.51