Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $192.12 / $217.74 / $217.74	Facility	26	$192.12	$217.74	$217.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.72 / $270.38 / $401.25	Professional		$212.72	$270.38	$401.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.35 / $139.03 / $217.74	Professional	26	$120.35	$139.03	$217.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.90 / $102.67 / $137.05	Professional	TC	$88.90	$102.67	$137.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.98 / $359.10 / $433.03	Professional		$296.98	$359.10	$433.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $177.32 / $216.31 / $260.85	Professional	26	$177.32	$216.31	$260.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.00 / $142.79 / $172.18	Professional	TC	$121.00	$142.79	$172.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $332.51 / $362.74 / $403.04	Professional		$332.51	$362.74	$403.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $206.02 / $218.51 / $249.72	Professional	26	$206.02	$218.51	$249.72
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $126.49 / $134.16 / $153.32	Professional	TC	$126.49	$134.16	$153.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $135.44 / $330.45	Professional		$32.34	$135.44	$330.45
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $946.29 / $946.29 / $946.29	Facility	26	$946.29	$946.29	$946.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $267.68 / $314.92 / $371.35	Professional		$267.68	$314.92	$371.35
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $163.22 / $192.04 / $231.47	Professional	26	$163.22	$192.04	$231.47
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $104.45 / $122.88 / $139.88	Professional	TC	$104.45	$122.88	$139.88
United Facility/Professional Professional Modifier Low / Median / High Price $242.35 / $324.50 / $441.32	Professional		$242.35	$324.50	$441.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $140.97 / $190.50 / $266.70	Professional	26	$140.97	$190.50	$266.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.64 / $134.27 / $186.00	Professional	TC	$98.64	$134.27	$186.00