Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.79 / $215.63 / $217.45	Facility	26	$81.79	$215.63	$217.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.20 / $475.00 / $679.81	Professional		$306.20	$475.00	$679.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.90 / $140.00 / $201.00	Professional	26	$63.90	$140.00	$201.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.93 / $335.00 / $499.00	Professional	TC	$224.93	$335.00	$499.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.98 / $206.74 / $625.10	Professional		$184.98	$206.74	$625.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.39 / $52.97 / $107.96	Professional	26	$47.39	$52.97	$107.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.59 / $153.77 / $514.97	Professional	TC	$137.59	$153.77	$514.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,005.50 / $1,005.50 / $1,350.40	Professional		$1,005.50	$1,005.50	$1,350.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $344.98 / $344.98 / $438.83	Professional	26	$344.98	$344.98	$438.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $660.52 / $660.52 / $911.57	Professional	TC	$660.52	$660.52	$911.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $350.11 / $403.16 / $524.61	Professional		$350.11	$403.16	$524.61
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.66 / $103.25 / $120.63	Professional	26	$89.66	$103.25	$120.63
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $260.45 / $299.92 / $350.43	Professional	TC	$260.45	$299.92	$350.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $91.33 / $302.39	Professional		$32.34	$91.33	$302.39
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 $387.20 / $455.53 / $524.61	Professional		$387.20	$455.53	$524.61
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.82 / $115.08 / $139.41	Professional	26	$97.82	$115.08	$139.41
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $289.38 / $340.45 / $385.19	Professional	TC	$289.38	$340.45	$385.19
United Facility/Professional Professional Modifier Low / Median / High Price $211.67 / $439.76 / $881.60	Professional		$211.67	$439.76	$881.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.76 / $64.59 / $115.60	Professional	26	$49.76	$64.59	$115.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.52 / $300.27 / $781.85	Professional	TC	$159.52	$300.27	$781.85