Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.53 / $159.72 / $159.72	Facility	26	$154.53	$159.72	$159.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $380.74 / $468.49	Professional		$275.00	$380.74	$468.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $69.00 / $134.22	Professional	26	$55.00	$69.00	$134.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $211.76 / $306.18 / $370.58	Professional	TC	$211.76	$306.18	$370.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.51 / $200.63 / $553.22	Professional		$179.51	$200.63	$553.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.99 / $55.87 / $130.19	Professional	26	$49.99	$55.87	$130.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.52 / $144.76 / $426.66	Professional	TC	$129.52	$144.76	$426.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,041.15 / $1,041.15 / $1,155.78	Professional		$1,041.15	$1,041.15	$1,155.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $352.67 / $352.67 / $426.56	Professional	26	$352.67	$352.67	$426.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $614.59 / $614.59 / $803.11	Professional	TC	$614.59	$614.59	$803.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $341.04 / $392.71 / $512.55	Professional		$341.04	$392.71	$512.55
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.01 / $109.40 / $127.83	Professional	26	$95.01	$109.40	$127.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $246.05 / $283.33 / $331.05	Professional	TC	$246.05	$283.33	$331.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $107.62 / $333.03	Professional		$32.34	$107.62	$333.03
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 $357.47 / $444.57 / $512.55	Professional		$357.47	$444.57	$512.55
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $103.64 / $121.93 / $146.59	Professional	26	$103.64	$121.93	$146.59
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $274.24 / $322.64 / $365.97	Professional	TC	$274.24	$322.64	$365.97
United Facility/Professional Professional Modifier Low / Median / High Price $213.81 / $334.16 / $727.64	Professional		$213.81	$334.16	$727.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.91 / $65.53 / $130.41	Professional	26	$54.91	$65.53	$130.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.90 / $274.27 / $549.83	Professional	TC	$158.90	$274.27	$549.83