Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $179.73 / $264.38 / $264.38	Facility	26	$179.73	$264.38	$264.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.30 / $494.18 / $848.41	Professional		$365.30	$494.18	$848.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.75 / $140.00 / $222.17	Professional	26	$78.75	$140.00	$222.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $286.55 / $368.50 / $626.24	Professional	TC	$286.55	$368.50	$626.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.72 / $261.22 / $604.20	Professional		$233.72	$261.22	$604.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.42 / $65.29 / $132.18	Professional	26	$58.42	$65.29	$132.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $175.30 / $195.92 / $484.52	Professional	TC	$175.30	$195.92	$484.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,432.77 / $1,432.77 / $1,590.51	Professional		$1,432.77	$1,432.77	$1,590.51
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $281.13 / $281.13 / $520.40	Professional	26	$281.13	$281.13	$520.40
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $912.37 / $912.37 / $1,309.38	Professional	TC	$912.37	$912.37	$1,309.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $425.37 / $489.82 / $648.66	Professional		$425.37	$489.82	$648.66
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $110.48 / $127.22 / $148.65	Professional	26	$110.48	$127.22	$148.65
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $314.89 / $362.60 / $423.66	Professional	TC	$314.89	$362.60	$423.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $125.17 / $414.82	Professional		$32.34	$125.17	$414.82
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $446.45	Facility	26	$446.45	$446.45	$446.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $474.54 / $558.28 / $648.66	Professional		$474.54	$558.28	$648.66
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $120.53 / $141.80 / $170.43	Professional	26	$120.53	$141.80	$170.43
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $354.01 / $416.48 / $478.23	Professional	TC	$354.01	$416.48	$478.23
United Facility/Professional Professional Modifier Low / Median / High Price $266.27 / $352.68 / $741.69	Professional		$266.27	$352.68	$741.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.76 / $79.80 / $142.80	Professional	26	$60.76	$79.80	$142.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.85 / $291.92 / $590.21	Professional	TC	$201.85	$291.92	$590.21