Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $152.71 / $152.71 / $152.71	Facility	26	$152.71	$152.71	$152.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.52 / $389.06 / $436.33	Professional		$258.52	$389.06	$436.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $69.23 / $132.63	Professional	26	$59.34	$69.23	$132.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.93 / $303.68 / $358.73	Professional	TC	$191.93	$303.68	$358.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.83 / $186.46 / $503.91	Professional		$166.83	$186.46	$503.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $55.21 / $124.38	Professional	26	$49.40	$55.21	$124.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.43 / $131.25 / $386.85	Professional	TC	$117.43	$131.25	$386.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,088.42 / $1,088.42 / $1,208.25	Professional		$1,088.42	$1,088.42	$1,208.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $522.90 / $522.90 / $522.90	Professional	26	$522.90	$522.90	$522.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $565.52 / $565.52 / $685.35	Professional	TC	$565.52	$565.52	$685.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $318.63 / $366.91 / $478.17	Professional		$318.63	$366.91	$478.17
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.93 / $108.17 / $126.38	Professional	26	$93.93	$108.17	$126.38
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $224.70 / $258.74 / $302.32	Professional	TC	$224.70	$258.74	$302.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $95.45 / $346.92	Professional		$32.34	$95.45	$346.92
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $346.39	Facility	26	$346.39	$346.39	$346.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $413.74 / $478.17	Professional		$350.00	$413.74	$478.17
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $101.90 / $119.88 / $144.49	Professional	26	$101.90	$119.88	$144.49
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $249.78 / $293.86 / $333.68	Professional	TC	$249.78	$293.86	$333.68
United Facility/Professional Professional Modifier Low / Median / High Price $200.32 / $304.37 / $610.16	Professional		$200.32	$304.37	$610.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.00 / $70.37 / $137.91	Professional	26	$57.00	$70.37	$137.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.51 / $247.37 / $512.08	Professional	TC	$140.51	$247.37	$512.08