Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.01 / $319.33 / $319.33	Facility	26	$218.01	$319.33	$319.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.32 / $488.59 / $857.99	Professional		$362.32	$488.59	$857.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.32 / $140.00 / $268.36	Professional	26	$95.32	$140.00	$268.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $181.16 / $301.50 / $429.00	Professional	52	$181.16	$301.50	$429.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $267.00 / $348.53 / $589.63	Professional	TC	$267.00	$348.53	$589.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.89 / $261.39 / $741.25	Professional		$233.89	$261.39	$741.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.55 / $78.84 / $160.44	Professional	26	$70.55	$78.84	$160.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.34 / $182.55 / $538.04	Professional	TC	$163.34	$182.55	$538.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,638.03 / $1,638.03 / $1,818.37	Professional		$1,638.03	$1,638.03	$1,818.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $596.26 / $596.26 / $725.16	Professional	26	$596.26	$596.26	$725.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $912.87 / $912.87 / $1,222.10	Professional	TC	$912.87	$912.87	$1,222.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $439.79 / $506.43 / $661.39	Professional		$439.79	$506.43	$661.39
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $133.96 / $154.26 / $180.24	Professional	26	$133.96	$154.26	$180.24
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $305.83 / $352.17 / $411.48	Professional	TC	$305.83	$352.17	$411.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $136.26 / $479.15	Professional		$32.34	$136.26	$479.15
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 $485.60 / $571.29 / $661.39	Professional		$485.60	$571.29	$661.39
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $145.56 / $171.25 / $207.01	Professional	26	$145.56	$171.25	$207.01
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $340.03 / $400.04 / $454.38	Professional	TC	$340.03	$400.04	$454.38
United Facility/Professional Professional Modifier Low / Median / High Price $266.58 / $460.60 / $971.12	Professional		$266.58	$460.60	$971.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.06 / $91.31 / $172.05	Professional	26	$74.06	$91.31	$172.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.96 / $351.58 / $802.20	Professional	TC	$188.96	$351.58	$802.20