Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.79 / $265.56 / $267.79	Facility	26	$100.79	$265.56	$267.79
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $69.23 / $69.23 / $100.09	Facility	53	$69.23	$69.23	$100.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.59 / $475.00 / $982.25	Professional		$331.59	$475.00	$982.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.78 / $140.00 / $263.89	Professional	26	$71.78	$140.00	$263.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $129.53 / $237.50 / $310.92	Professional	52	$129.53	$237.50	$310.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.08 / $335.00 / $454.49	Professional	TC	$186.08	$335.00	$454.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.70 / $188.54 / $555.69	Professional		$168.70	$188.54	$555.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.42 / $65.29 / $133.38	Professional	26	$58.42	$65.29	$133.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.27 / $123.25 / $425.73	Professional	TC	$110.27	$123.25	$425.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,005.50 / $1,005.50 / $1,394.96	Professional		$1,005.50	$1,005.50	$1,394.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $566.09 / $566.09 / $578.41	Professional	26	$566.09	$566.09	$578.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $439.41 / $439.41 / $816.54	Professional	TC	$439.41	$439.41	$816.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $319.16 / $367.52 / $479.51	Professional		$319.16	$367.52	$479.51
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $111.01 / $127.83 / $149.36	Professional	26	$111.01	$127.83	$149.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.15 / $252.30 / $319.16	Professional	TC	$208.15	$252.30	$319.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $112.84 / $348.54	Professional		$32.34	$112.84	$348.54
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 $352.27 / $414.43 / $479.51	Professional		$352.27	$414.43	$479.51
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $121.11 / $142.47 / $171.97	Professional	26	$121.11	$142.47	$171.97
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $231.16 / $271.95 / $307.54	Professional	TC	$231.16	$271.95	$307.54
United Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $362.62 / $869.26	Professional		$192.64	$362.62	$869.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.05 / $76.15 / $143.47	Professional	26	$61.05	$76.15	$143.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $246.83 / $730.18	Professional	TC	$127.91	$246.83	$730.18