Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.25 / $241.66 / $241.66	Facility	26	$164.25	$241.66	$241.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.52 / $494.18 / $720.48	Professional		$307.52	$494.18	$720.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.56 / $140.00 / $203.08	Professional	26	$71.56	$140.00	$203.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $235.98 / $340.00 / $517.40	Professional	TC	$235.98	$340.00	$517.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.49 / $220.72 / $631.36	Professional		$197.49	$220.72	$631.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.14 / $59.39 / $121.20	Professional	26	$53.14	$59.39	$121.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.35 / $161.33 / $487.17	Professional	TC	$144.35	$161.33	$487.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,408.46 / $1,408.46 / $1,563.53	Professional		$1,408.46	$1,408.46	$1,563.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $524.95 / $524.95 / $556.66	Professional	26	$524.95	$524.95	$556.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $851.80 / $851.80 / $1,038.58	Professional	TC	$851.80	$851.80	$1,038.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $366.66 / $422.22 / $553.28	Professional		$366.66	$422.22	$553.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.86 / $116.15 / $135.71	Professional	26	$100.86	$116.15	$135.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $265.80 / $306.07 / $357.62	Professional	TC	$265.80	$306.07	$357.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $114.39 / $358.12	Professional		$32.34	$114.39	$358.12
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $446.45	Facility	26	$446.45	$446.45	$446.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $406.41 / $478.13 / $553.28	Professional		$406.41	$478.13	$553.28
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $110.05 / $129.47 / $155.79	Professional	26	$110.05	$129.47	$155.79
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $296.37 / $348.67 / $397.49	Professional	TC	$296.37	$348.67	$397.49
United Facility/Professional Professional Modifier Low / Median / High Price $225.17 / $395.21 / $742.54	Professional		$225.17	$395.21	$742.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $72.00 / $129.19	Professional	26	$55.84	$72.00	$129.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.88 / $339.37 / $692.57	Professional	TC	$166.88	$339.37	$692.57