Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.39 / $107.36 / $108.26	Facility	26	$58.39	$107.36	$108.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.73 / $258.32 / $493.56	Professional		$165.73	$258.32	$493.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.58 / $57.37 / $131.09	Professional	26	$41.58	$57.37	$131.09
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $78.42 / $140.84 / $143.13	Professional	52	$78.42	$140.84	$143.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.11 / $191.46 / $231.46	Professional	TC	$120.11	$191.46	$231.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.24 / $119.86 / $345.00	Professional		$107.24	$119.86	$345.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.77 / $37.74 / $78.36	Professional	26	$33.77	$37.74	$78.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.47 / $82.12 / $242.03	Professional	TC	$73.47	$82.12	$242.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $507.78 / $507.78 / $680.60	Professional		$507.78	$507.78	$680.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $253.33 / $253.33 / $377.30	Professional	26	$253.33	$253.33	$377.30
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $254.45 / $254.45 / $303.30	Professional	TC	$254.45	$254.45	$303.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $208.15 / $239.69 / $311.89	Professional		$208.15	$239.69	$311.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.58 / $74.37 / $86.89	Professional	26	$64.58	$74.37	$86.89
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $143.57 / $165.32 / $193.16	Professional	TC	$143.57	$165.32	$193.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $73.11 / $203.61	Professional		$32.34	$73.11	$203.61
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $229.41 / $269.89 / $311.89	Professional		$229.41	$269.89	$311.89
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $69.87 / $82.20 / $99.30	Professional	26	$69.87	$82.20	$99.30
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $159.54 / $187.69 / $212.59	Professional	TC	$159.54	$187.69	$212.59
United Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $213.23 / $427.47	Professional		$120.25	$213.23	$427.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.43 / $47.16 / $94.54	Professional	26	$37.43	$47.16	$94.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.82 / $166.07 / $332.93	Professional	TC	$82.82	$166.07	$332.93