Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.09 / $174.23 / $175.70	Facility	26	$94.09	$174.23	$175.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.95 / $314.02 / $419.91	Professional		$239.95	$314.02	$419.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $92.96 / $180.99	Professional	26	$59.34	$92.96	$180.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $166.43 / $251.06 / $285.00	Professional	TC	$166.43	$251.06	$285.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.38 / $174.78 / $416.06	Professional		$156.38	$174.78	$416.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.55 / $60.97 / $124.38	Professional	26	$54.55	$60.97	$124.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.83 / $113.81 / $309.54	Professional	TC	$101.83	$113.81	$309.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $597.77 / $597.77 / $815.64	Professional		$597.77	$597.77	$815.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $523.97 / $523.97 / $523.97	Professional	26	$523.97	$523.97	$523.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.80 / $73.80 / $291.67	Professional	TC	$73.80	$73.80	$291.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $195.34 / $317.00 / $450.53	Professional		$195.34	$317.00	$450.53
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $103.54 / $119.23 / $139.31	Professional	26	$103.54	$119.23	$139.31
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $195.34 / $224.94 / $317.00	Professional	TC	$195.34	$224.94	$317.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $105.39 / $326.49	Professional		$32.34	$105.39	$326.49
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 / $450.53	Professional		$330.14	$388.40	$450.53
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $112.96 / $132.88 / $160.68	Professional	26	$112.96	$132.88	$160.68
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $217.18 / $255.51 / $289.85	Professional	TC	$217.18	$255.51	$289.85
United Facility/Professional Professional Modifier Low / Median / High Price $174.85 / $250.84 / $502.87	Professional		$174.85	$250.84	$502.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.29 / $74.48 / $140.65	Professional	26	$57.29	$74.48	$140.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.72 / $193.55 / $409.48	Professional	TC	$114.72	$193.55	$409.48