Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.07 / $19.07 / $19.07	Facility	26	$19.07	$19.07	$19.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $80.67 / $180.48	Professional		$68.06	$80.67	$180.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $32.54 / $45.41	Professional	26	$18.60	$32.54	$45.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.22 / $59.30 / $95.59	Professional	TC	$50.22	$59.30	$95.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $121.16 / $128.50 / $146.86	Professional		$121.16	$128.50	$146.86
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.08 / $35.09 / $40.10	Professional	26	$33.08	$35.09	$40.10
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 $30.00 / $32.34 / $131.43	Professional		$30.00	$32.34	$131.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $112.44 / $113.09 / $116.72	Professional		$112.44	$113.09	$116.72
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $30.35 / $31.93	Professional	26	$28.60	$30.35	$31.93
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $82.09 / $84.49 / $84.79	Professional	TC	$82.09	$84.49	$84.79
United Facility/Professional Professional Modifier Low / Median / High Price $80.56 / $108.08 / $165.48	Professional		$80.56	$108.08	$165.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $25.12 / $40.17	Professional	26	$22.04	$25.12	$40.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.52 / $84.66 / $120.85	Professional	TC	$58.52	$84.66	$120.85