Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.19 / $203.44 / $203.44	Facility	26	$111.19	$203.44	$203.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $380.46 / $492.72	Professional		$275.00	$380.46	$492.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $78.56 / $170.96	Professional	26	$62.17	$78.56	$170.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $203.83 / $314.49 / $345.93	Professional	TC	$203.83	$314.49	$345.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.96 / $211.19 / $501.87	Professional		$188.96	$211.19	$501.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.23 / $71.80 / $145.36	Professional	26	$64.23	$71.80	$145.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.72 / $139.38 / $387.70	Professional	TC	$124.72	$139.38	$387.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,015.50 / $1,015.50 / $1,127.30	Professional		$1,015.50	$1,015.50	$1,127.30
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $528.94 / $528.94 / $611.29	Professional	26	$528.94	$528.94	$611.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $486.56 / $486.56 / $516.00	Professional	TC	$486.56	$486.56	$516.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $358.66 / $413.00 / $541.53	Professional		$358.66	$413.00	$541.53
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.16 / $139.52 / $150.88	Professional	26	$121.16	$139.52	$150.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $237.50 / $273.49 / $319.55	Professional	TC	$237.50	$273.49	$319.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $123.34 / $351.56	Professional		$32.34	$123.34	$351.56
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 $374.54 / $465.80 / $541.54	Professional		$374.54	$465.80	$541.54
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $131.59 / $154.81 / $187.10	Professional	26	$131.59	$154.81	$187.10
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $264.33 / $310.99 / $354.44	Professional	TC	$264.33	$310.99	$354.44
United Facility/Professional Professional Modifier Low / Median / High Price $211.36 / $301.47 / $578.65	Professional		$211.36	$301.47	$578.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.89 / $87.54 / $147.10	Professional	26	$59.89	$87.54	$147.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.50 / $241.58 / $484.29	Professional	TC	$140.50	$241.58	$484.29