Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.50 / $219.84 / $230.92	Facility	26	$119.50	$219.84	$230.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $310.64 / $446.12 / $559.54	Professional		$310.64	$446.12	$559.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.65 / $109.69 / $192.03	Professional	26	$75.65	$109.69	$192.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.28 / $351.12 / $386.24	Professional	TC	$217.28	$351.12	$386.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.14 / $257.20 / $758.10	Professional		$230.14	$257.20	$758.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.14 / $77.27 / $157.28	Professional	26	$69.14	$77.27	$157.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.00 / $179.94 / $539.79	Professional	TC	$161.00	$179.94	$539.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $783.87 / $783.87 / $1,305.83	Professional		$783.87	$783.87	$1,305.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $328.77 / $328.77 / $329.53	Professional	26	$328.77	$328.77	$329.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $455.10 / $455.10 / $976.30	Professional	TC	$455.10	$455.10	$976.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $449.39 / $517.48 / $671.12	Professional		$449.39	$517.48	$671.12
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.29 / $151.18 / $176.65	Professional	26	$131.29	$151.18	$176.65
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $318.10 / $366.30 / $427.99	Professional	TC	$318.10	$366.30	$427.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $133.53 / $463.52	Professional		$32.34	$133.53	$463.52
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 $467.63 / $581.57 / $671.11	Professional		$467.63	$581.57	$671.11
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $142.66 / $167.83 / $202.89	Professional	26	$142.66	$167.83	$202.89
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $350.00 / $413.74 / $468.22	Professional	TC	$350.00	$413.74	$468.22
United Facility/Professional Professional Modifier Low / Median / High Price $256.14 / $477.67 / $1,026.75	Professional		$256.14	$477.67	$1,026.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.62 / $94.24 / $175.69	Professional	26	$72.62	$94.24	$175.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.07 / $405.05 / $812.01	Professional	TC	$180.07	$405.05	$812.01