Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $322.19 / $322.19 / $322.19	Facility	26	$322.19	$322.19	$322.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.76 / $494.18 / $1,061.18	Professional		$455.76	$494.18	$1,061.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.00 / $140.00 / $380.94	Professional	26	$96.00	$140.00	$380.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $359.77 / $790.43	Professional	TC	$335.00	$359.77	$790.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.20 / $325.47 / $743.43	Professional		$291.20	$325.47	$743.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.18 / $79.55 / $160.90	Professional	26	$71.18	$79.55	$160.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.03 / $245.91 / $595.66	Professional	TC	$220.03	$245.91	$595.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,858.15 / $1,858.15 / $2,062.71	Professional		$1,858.15	$1,858.15	$2,062.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $608.21 / $608.21 / $609.63	Professional	26	$608.21	$608.21	$609.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,248.52 / $1,248.52 / $1,454.51	Professional	TC	$1,248.52	$1,248.52	$1,454.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $540.66 / $622.57 / $813.90	Professional		$540.66	$622.57	$813.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.49 / $154.87 / $180.95	Professional	26	$134.49	$154.87	$180.95
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $406.16 / $467.70 / $546.48	Professional	TC	$406.16	$467.70	$546.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $152.57 / $527.07	Professional		$32.34	$152.57	$527.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $599.72 / $705.55 / $813.91	Professional		$599.72	$705.55	$813.91
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $146.15 / $171.94 / $208.06	Professional	26	$146.15	$171.94	$208.06
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $453.58 / $533.62 / $605.85	Professional	TC	$453.58	$533.62	$605.85
United Facility/Professional Professional Modifier Low / Median / High Price $331.61 / $443.82 / $966.42	Professional		$331.61	$443.82	$966.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.23 / $96.52 / $174.21	Professional	26	$75.23	$96.52	$174.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.69 / $368.59 / $766.19	Professional	TC	$253.69	$368.59	$766.19