Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.40 / $141.60 / $141.60	Facility	26	$77.40	$141.60	$141.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.10 / $372.00 / $409.21	Professional		$237.10	$372.00	$409.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.50 / $69.47 / $135.65	Professional	26	$59.50	$69.47	$135.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.63 / $280.42 / $339.73	Professional	TC	$176.63	$280.42	$339.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.87 / $170.85 / $490.43	Professional		$152.87	$170.85	$490.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.80 / $50.07 / $124.38	Professional	26	$44.80	$50.07	$124.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.07 / $120.78 / $380.75	Professional	TC	$108.07	$120.78	$380.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $872.35 / $872.35 / $968.39	Professional		$872.35	$872.35	$968.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $238.89 / $238.89 / $330.59	Professional	26	$238.89	$238.89	$330.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $541.76 / $541.76 / $729.50	Professional	TC	$541.76	$541.76	$729.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $293.01 / $337.40 / $439.39	Professional		$293.01	$337.40	$439.39
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.86 / $97.72 / $114.17	Professional	26	$84.86	$97.72	$114.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.15 / $239.69 / $280.05	Professional	TC	$208.15	$239.69	$280.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $96.21 / $286.30	Professional		$32.34	$96.21	$286.30
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $346.39	Facility	26	$346.39	$346.39	$346.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $323.73 / $380.86 / $439.39	Professional		$323.73	$380.86	$439.39
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $92.58 / $108.92 / $131.08	Professional	26	$92.58	$108.92	$131.08
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $231.16 / $271.95 / $308.31	Professional	TC	$231.16	$271.95	$308.31
United Facility/Professional Professional Modifier Low / Median / High Price $192.95 / $298.58 / $660.03	Professional		$192.95	$298.58	$660.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.08 / $60.80 / $120.09	Professional	26	$49.08	$60.80	$120.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.87 / $241.29 / $517.51	Professional	TC	$143.87	$241.29	$517.51