Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.13 / $214.46 / $214.46	Facility	26	$146.13	$214.46	$214.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.55 / $475.00 / $716.42	Professional		$304.55	$475.00	$716.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.90 / $140.00 / $180.22	Professional	26	$63.90	$140.00	$180.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.65 / $340.00 / $536.20	Professional	TC	$240.65	$340.00	$536.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.60 / $217.50 / $652.88	Professional		$194.60	$217.50	$652.88
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 $147.21 / $164.53 / $511.73	Professional	TC	$147.21	$164.53	$511.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,530.00 / $1,530.00 / $1,698.44	Professional		$1,530.00	$1,530.00	$1,698.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $359.59 / $359.59 / $580.12	Professional	26	$359.59	$359.59	$580.12
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $949.88 / $949.88 / $1,338.85	Professional	TC	$949.88	$949.88	$1,338.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $280.20 / $392.28 / $553.04	Professional		$280.20	$392.28	$553.04
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 $280.20 / $322.66 / $377.00	Professional	TC	$280.20	$322.66	$377.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $101.77 / $360.41	Professional		$32.34	$101.77	$360.41
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $714.15 / $714.15 / $714.15	Facility	26	$714.15	$714.15	$714.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $408.16 / $480.19 / $553.04	Professional		$408.16	$480.19	$553.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.82 / $115.08 / $138.65	Professional	26	$97.82	$115.08	$138.65
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $310.33 / $365.11 / $414.40	Professional	TC	$310.33	$365.11	$414.40
United Facility/Professional Professional Modifier Low / Median / High Price $221.18 / $432.24 / $866.52	Professional		$221.18	$432.24	$866.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.47 / $65.26 / $115.60	Professional	26	$49.47	$65.26	$115.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.03 / $382.77 / $767.35	Professional	TC	$169.03	$382.77	$767.35