Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.53 / $154.53 / $154.53	Facility	26	$154.53	$154.53	$154.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.26 / $391.18 / $430.29	Professional		$242.26	$391.18	$430.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.97 / $71.18 / $134.22	Professional	26	$60.97	$71.18	$134.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.51 / $276.25 / $359.11	Professional	TC	$174.51	$276.25	$359.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.02 / $175.49 / $503.00	Professional		$157.02	$175.49	$503.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.25 / $56.16 / $115.21	Professional	26	$50.25	$56.16	$115.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.77 / $119.33 / $352.02	Professional	TC	$106.77	$119.33	$352.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $958.78 / $958.78 / $1,064.33	Professional		$958.78	$958.78	$1,064.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $387.93 / $387.93 / $469.22	Professional	26	$387.93	$387.93	$469.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $489.56 / $489.56 / $676.40	Professional	TC	$489.56	$489.56	$676.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $298.88 / $344.17 / $450.29	Professional		$298.88	$344.17	$450.29
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 $203.87 / $234.76 / $274.30	Professional	TC	$203.87	$234.76	$274.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $96.58 / $259.01	Professional		$32.34	$96.58	$259.01
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 $330.14 / $388.40 / $450.28	Professional		$330.14	$388.40	$450.28
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $103.64 / $121.93 / $147.36	Professional	26	$103.64	$121.93	$147.36
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $226.50 / $266.47 / $302.92	Professional	TC	$226.50	$266.47	$302.92
United Facility/Professional Professional Modifier Low / Median / High Price $175.77 / $310.44 / $622.33	Professional		$175.77	$310.44	$622.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $68.40 / $129.91	Professional	26	$55.22	$68.40	$129.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.55 / $251.70 / $504.58	Professional	TC	$120.55	$251.70	$504.58