Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.12 / $410.12 / $413.56	Facility	26	$157.12	$410.12	$413.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $522.50 / $1,014.36	Professional		$400.00	$522.50	$1,014.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.75 / $167.64 / $386.40	Professional	26	$122.75	$167.64	$386.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $202.92 / $301.50 / $507.18	Professional	52	$202.92	$301.50	$507.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $303.97 / $368.50 / $669.72	Professional	TC	$303.97	$368.50	$669.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.83 / $309.39 / $931.33	Professional		$276.83	$309.39	$931.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.87 / $101.56 / $205.33	Professional	26	$90.87	$101.56	$205.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.97 / $207.84 / $628.76	Professional	TC	$185.97	$207.84	$628.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,199.50 / $1,199.50 / $2,382.10	Professional		$1,199.50	$1,199.50	$2,382.10
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $891.79 / $891.79 / $891.79	Professional	26	$891.79	$891.79	$891.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $307.70 / $307.70 / $1,490.31	Professional	TC	$307.70	$307.70	$1,490.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $518.23 / $596.75 / $780.64	Professional		$518.23	$596.75	$780.64
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $172.92 / $199.12 / $232.66	Professional	26	$172.92	$199.12	$232.66
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $345.31 / $397.63 / $464.60	Professional	TC	$345.31	$397.63	$464.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $175.18 / $449.02	Professional		$32.34	$175.18	$449.02
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 $550.00 / $672.67 / $780.64	Professional		$550.00	$672.67	$780.64
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $186.91 / $219.89 / $265.52	Professional	26	$186.91	$219.89	$265.52
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $384.87 / $452.79 / $515.12	Professional	TC	$384.87	$452.79	$515.12
United Facility/Professional Professional Modifier Low / Median / High Price $315.04 / $559.54 / $1,179.74	Professional		$315.04	$559.54	$1,179.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.80 / $123.50 / $221.00	Professional	26	$97.80	$123.50	$221.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.34 / $405.36 / $973.55	Professional	TC	$215.34	$405.36	$973.55