Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.37 / $166.37 / $187.90	Facility	26	$166.37	$166.37	$187.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.20 / $347.33 / $487.30	Professional		$275.20	$347.33	$487.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.31 / $106.79 / $156.32	Professional	26	$94.31	$106.79	$156.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.03 / $253.00 / $330.97	Professional	TC	$176.03	$253.00	$330.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.28 / $419.14 / $496.43	Professional		$349.28	$419.14	$496.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.44 / $167.92 / $200.14	Professional	26	$128.44	$167.92	$200.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $202.84 / $243.41 / $320.14	Professional	TC	$202.84	$243.41	$320.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $464.87 / $493.05 / $563.48	Professional		$464.87	$493.05	$563.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $159.04 / $168.68 / $192.78	Professional	26	$159.04	$168.68	$192.78
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $305.83 / $324.36 / $370.70	Professional	TC	$305.83	$324.36	$370.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $180.18 / $455.21	Professional		$32.34	$180.18	$455.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $356.66 / $437.80 / $476.49	Professional		$356.66	$437.80	$476.49
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $126.44 / $148.75 / $179.70	Professional	26	$126.44	$148.75	$179.70
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $218.99 / $289.05 / $296.77	Professional	TC	$218.99	$289.05	$296.77
United Facility/Professional Professional Modifier Low / Median / High Price $275.12 / $420.32 / $644.41	Professional		$275.12	$420.32	$644.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.41 / $147.00 / $199.91	Professional	26	$108.41	$147.00	$199.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.40 / $292.41 / $488.95	Professional	TC	$163.40	$292.41	$488.95