Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $219.83 / $323.20 / $323.20	Facility	26	$219.83	$323.20	$323.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $463.89 / $494.18 / $1,089.73	Professional		$463.89	$494.18	$1,089.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.48 / $140.00 / $271.60	Professional	26	$96.48	$140.00	$271.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $367.42 / $818.13	Professional	TC	$335.00	$367.42	$818.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.11 / $330.95 / $993.21	Professional		$296.11	$330.95	$993.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.40 / $79.80 / $161.78	Professional	26	$71.40	$79.80	$161.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.71 / $251.15 / $879.89	Professional	TC	$224.71	$251.15	$879.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,241.66 / $2,241.66 / $2,488.44	Professional		$2,241.66	$2,241.66	$2,488.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $687.32 / $687.32 / $814.74	Professional	26	$687.32	$687.32	$814.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,426.92 / $1,426.92 / $1,801.13	Professional	TC	$1,426.92	$1,426.92	$1,801.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $561.48 / $646.54 / $840.72	Professional		$561.48	$646.54	$840.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.04 / $155.50 / $181.68	Professional	26	$135.04	$155.50	$181.68
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $426.44 / $491.06 / $573.76	Professional	TC	$426.44	$491.06	$573.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $153.09 / $547.04	Professional		$32.34	$153.09	$547.04
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 $587.15 / $730.21 / $840.72	Professional		$587.15	$730.21	$840.72
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $146.72 / $172.62 / $208.74	Professional	26	$146.72	$172.62	$208.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $473.95 / $557.59 / $631.99	Professional	TC	$473.95	$557.59	$631.99
United Facility/Professional Professional Modifier Low / Median / High Price $336.52 / $677.01 / $1,357.20	Professional		$336.52	$677.01	$1,357.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.36 / $97.28 / $174.08	Professional	26	$74.36	$97.28	$174.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.98 / $602.65 / $1,208.13	Professional	TC	$257.98	$602.65	$1,208.13