Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.10 / $131.10 / $131.10	Facility	26	$131.10	$131.10	$131.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.78 / $170.26 / $250.18	Professional		$133.78	$170.26	$250.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $83.60 / $135.88	Professional	26	$72.04	$83.60	$135.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.89 / $68.64 / $95.34	Professional	TC	$60.89	$68.64	$95.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.02 / $227.28 / $274.07	Professional		$186.02	$227.28	$274.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.12 / $129.75 / $156.46	Professional	26	$106.12	$129.75	$156.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.00 / $97.53 / $117.61	Professional	TC	$81.00	$97.53	$117.61
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $211.89 / $231.16 / $256.83	Professional		$211.89	$231.16	$256.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.82 / $131.32 / $150.08	Professional	26	$123.82	$131.32	$150.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.06 / $93.40 / $106.74	Professional	TC	$88.06	$93.40	$106.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $84.56 / $210.35	Professional		$32.34	$84.56	$210.35
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $513.03 / $513.03 / $513.03	Facility	26	$513.03	$513.03	$513.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $170.00 / $200.00 / $234.61	Professional		$170.00	$200.00	$234.61
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $98.11 / $115.42 / $139.56	Professional	26	$98.11	$115.42	$139.56
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $71.89 / $84.58 / $95.05	Professional	TC	$71.89	$84.58	$95.05
United Facility/Professional Professional Modifier Low / Median / High Price $148.69 / $205.50 / $280.16	Professional		$148.69	$205.50	$280.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.36 / $114.00 / $156.41	Professional	26	$84.36	$114.00	$156.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.87 / $90.57 / $124.00	Professional	TC	$65.87	$90.57	$124.00