Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.94 / $215.63 / $215.63	Facility	26	$146.94	$215.63	$215.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.10 / $475.00 / $681.79	Professional		$290.10	$475.00	$681.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.33 / $140.00 / $181.21	Professional	26	$64.33	$140.00	$181.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.78 / $340.00 / $500.58	Professional	TC	$225.78	$340.00	$500.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.76 / $207.61 / $627.79	Professional		$185.76	$207.61	$627.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.65 / $53.26 / $107.96	Professional	26	$47.65	$53.26	$107.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.11 / $154.35 / $513.53	Professional	TC	$138.11	$154.35	$513.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,272.07 / $1,272.07 / $1,412.12	Professional		$1,272.07	$1,272.07	$1,412.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $503.34 / $503.34 / $523.97	Professional	26	$503.34	$503.34	$523.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $768.73 / $768.73 / $888.15	Professional	TC	$768.73	$768.73	$888.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $351.19 / $404.40 / $525.38	Professional		$351.19	$404.40	$525.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $90.21 / $103.87 / $121.37	Professional	26	$90.21	$103.87	$121.37
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $260.98 / $300.52 / $351.14	Professional	TC	$260.98	$300.52	$351.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $102.34 / $342.42	Professional		$32.34	$102.34	$342.42
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 $387.78 / $456.21 / $525.38	Professional		$387.78	$456.21	$525.38
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 $289.95 / $341.13 / $385.96	Professional	TC	$289.95	$341.13	$385.96
United Facility/Professional Professional Modifier Low / Median / High Price $212.59 / $438.90 / $879.86	Professional		$212.59	$438.90	$879.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.76 / $64.98 / $116.95	Professional	26	$49.76	$64.98	$116.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.13 / $354.96 / $816.47	Professional	TC	$160.13	$354.96	$816.47