Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,407.00 / $4,500.00 / $7,045.00	Facility		$1,407.00	$4,500.00	$7,045.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.30 / $550.28 / $1,050.43	Professional		$370.30	$550.28	$1,050.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $132.90 / $163.75 / $341.97	Professional	26	$132.90	$163.75	$341.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $237.40 / $390.49 / $708.46	Professional	TC	$237.40	$390.49	$708.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $543.02 / $619.29 / $742.13	Professional		$543.02	$619.29	$742.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $178.59 / $210.96 / $244.07	Professional	26	$178.59	$210.96	$244.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $348.78 / $391.94 / $498.06	Professional	TC	$348.78	$391.94	$498.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $413.83 / $704.36 / $1,129.88	Facility		$413.83	$704.36	$1,129.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $574.28 / $609.09 / $696.10	Professional		$574.28	$609.09	$696.10
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.07 / $199.07 / $241.30	Professional	26	$199.07	$199.07	$241.30
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $375.21 / $375.21 / $454.80	Professional	TC	$375.21	$375.21	$454.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $319.36 / $558.29	Professional		$32.34	$319.36	$558.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $968.17 / $1,594.64 / $2,085.51	Facility		$968.17	$1,594.64	$2,085.51
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,115.05 / $1,115.05 / $1,115.05	Facility	26	$1,115.05	$1,115.05	$1,115.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $588.74 / $588.74 / $719.93	Professional		$588.74	$588.74	$719.93
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $189.25 / $189.25 / $236.65	Professional	26	$189.25	$189.25	$236.65
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $399.48 / $399.48 / $483.28	Professional	TC	$399.48	$399.48	$483.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,620.00 / $4,150.00 / $4,441.00	Facility		$2,620.00	$4,150.00	$4,441.00
United Facility/Professional Professional Modifier Low / Median / High Price $362.88 / $480.16 / $776.16	Professional		$362.88	$480.16	$776.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $181.50 / $270.85	Professional	26	$132.09	$181.50	$270.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.24 / $301.77 / $497.71	Professional	TC	$227.24	$301.77	$497.71