Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.22 / $89.87 / $91.88	Facility	26	$68.22	$89.87	$91.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.22 / $185.43 / $440.33	Professional		$104.22	$185.43	$440.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.45 / $62.43 / $102.75	Professional	26	$46.45	$62.43	$102.75
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.53 / $64.06 / $103.75	Professional	52	$46.53	$64.06	$103.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.02 / $95.79 / $151.75	Professional	TC	$52.02	$95.79	$151.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.49 / $170.76 / $262.01	Professional		$139.49	$170.76	$262.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.69 / $77.63 / $103.28	Professional	26	$64.69	$77.63	$103.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.80 / $91.56 / $169.66	Professional	TC	$74.80	$91.56	$169.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $153.71 / $163.03 / $288.00	Professional		$153.71	$163.03	$288.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.84 / $75.11 / $89.36	Professional	26	$68.84	$75.11	$89.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.03 / $90.00 / $112.72	Professional	TC	$73.03	$90.00	$112.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $71.94 / $151.60	Professional		$32.34	$71.94	$151.60
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 $102.24 / $140.79 / $160.09	Professional		$102.24	$140.79	$160.09
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $46.61 / $64.18 / $78.38	Professional	26	$46.61	$64.18	$78.38
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $55.63 / $76.61 / $81.70	Professional	TC	$55.63	$76.61	$81.70
United Facility/Professional Professional Modifier Low / Median / High Price $125.40 / $243.00 / $452.32	Professional		$125.40	$243.00	$452.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.63 / $81.76 / $114.00	Professional	26	$48.63	$81.76	$114.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.77 / $132.44 / $196.89	Professional	TC	$76.77	$132.44	$196.89