Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $111.62 / $166.05	Professional		$67.48	$111.62	$166.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $19.34 / $28.45	Professional	26	$16.73	$19.34	$28.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.77 / $83.17 / $147.55	Professional	TC	$49.77	$83.17	$147.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.20 / $110.64 / $136.97	Professional		$92.20	$110.64	$136.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.94 / $30.73 / $36.63	Professional	26	$22.94	$30.73	$36.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.40 / $78.48 / $114.05	Professional	TC	$65.40	$78.48	$114.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $64.80 / $100.13 / $181.82	Facility		$64.80	$100.13	$181.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $76.86 / $112.09 / $135.40	Professional		$76.86	$112.09	$135.40
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.83 / $30.57 / $34.94	Professional	26	$28.83	$30.57	$34.94
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $76.86 / $88.50 / $115.29	Professional	TC	$76.86	$88.50	$115.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $42.15 / $103.09	Professional		$25.98	$42.15	$103.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $411.45 / $733.57 / $951.01	Facility		$411.45	$733.57	$951.01
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 $85.43 / $100.50 / $114.17	Professional		$85.43	$100.50	$114.17
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $26.87 / $32.74	Professional	26	$22.84	$26.87	$32.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $62.59 / $73.63 / $81.43	Professional	TC	$62.59	$73.63	$81.43
United Facility/Professional Professional Modifier Low / Median / High Price $71.44 / $131.50 / $257.52	Professional		$71.44	$131.50	$257.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $26.50 / $36.04	Professional	26	$19.23	$26.50	$36.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.30 / $105.49 / $219.52	Professional	TC	$51.30	$105.49	$219.52