Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.00 / $225.00 / $328.18	Facility		$225.00	$225.00	$328.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.16 / $88.16 / $88.16	Facility	26	$88.16	$88.16	$88.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $225.03 / $438.02	Professional		$165.00	$225.03	$438.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.74 / $59.62 / $103.37	Professional	26	$42.74	$59.62	$103.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.59 / $163.54 / $196.80	Professional	TC	$116.59	$163.54	$196.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.53 / $273.50 / $311.95	Professional		$214.53	$273.50	$311.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.59 / $71.51 / $82.00	Professional	26	$59.59	$71.51	$82.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.53 / $195.03 / $230.53	Professional	TC	$153.53	$195.03	$230.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $149.01 / $262.55 / $303.57	Facility		$149.01	$262.55	$303.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $205.47 / $224.15 / $256.58	Professional		$205.47	$224.15	$256.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.38 / $65.09 / $74.40	Professional	26	$61.38	$65.09	$74.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.11 / $152.85 / $174.68	Professional	TC	$144.11	$152.85	$174.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $69.95 / $201.04	Professional		$32.34	$69.95	$201.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $281.58 / $397.02 / $485.01	Facility		$281.58	$397.02	$485.01
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $270.73 / $270.73 / $270.73	Facility	26	$270.73	$270.73	$270.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.90 / $202.98 / $256.58	Professional		$165.90	$202.98	$256.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $42.00 / $57.71 / $72.16	Professional	26	$42.00	$57.71	$72.16
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $123.48 / $145.27 / $184.43	Professional	TC	$123.48	$145.27	$184.43
United Facility/Professional Professional Modifier Low / Median / High Price $170.28 / $243.36 / $356.62	Professional		$170.28	$243.36	$356.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.84 / $66.61 / $89.93	Professional	26	$44.84	$66.61	$89.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.31 / $178.74 / $244.99	Professional	TC	$126.31	$178.74	$244.99