Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.25 / $404.36 / $404.36	Facility	26	$154.25	$404.36	$404.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $568.40 / $1,413.19	Professional		$475.00	$568.40	$1,413.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.40 / $145.65 / $339.80	Professional	26	$118.40	$145.65	$339.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $447.88 / $1,073.40	Professional	TC	$335.00	$447.88	$1,073.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $418.35 / $467.56 / $1,122.59	Professional		$418.35	$467.56	$1,122.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.33 / $99.84 / $202.75	Professional	26	$89.33	$99.84	$202.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $329.01 / $367.72 / $966.74	Professional	TC	$329.01	$367.72	$966.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,406.41 / $2,406.41 / $2,671.34	Professional		$2,406.41	$2,406.41	$2,671.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $759.29 / $759.29 / $836.20	Professional	26	$759.29	$759.29	$836.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,647.12 / $1,647.12 / $1,835.14	Professional	TC	$1,647.12	$1,647.12	$1,835.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $761.61 / $877.00 / $1,155.57	Professional		$761.61	$877.00	$1,155.57
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $170.79 / $196.67 / $229.79	Professional	26	$170.79	$196.67	$229.79
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $590.83 / $680.35 / $794.94	Professional	TC	$590.83	$680.35	$794.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $192.72 / $739.39	Professional		$32.34	$192.72	$739.39
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 $803.67 / $996.68 / $1,155.57	Professional		$803.67	$996.68	$1,155.57
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $184.58 / $217.15 / $262.17	Professional	26	$184.58	$217.15	$262.17
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $634.39 / $779.53 / $893.40	Professional	TC	$634.39	$779.53	$893.40
United Facility/Professional Professional Modifier Low / Median / High Price $477.94 / $652.41 / $1,363.34	Professional		$477.94	$652.41	$1,363.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.45 / $120.83 / $216.23	Professional	26	$93.45	$120.83	$216.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $380.39 / $558.97 / $1,120.57	Professional	TC	$380.39	$558.97	$1,120.57