Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.27 / $153.36 / $153.36	Facility	26	$83.27	$153.36	$153.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.17 / $315.56 / $373.85	Professional		$219.17	$315.56	$373.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $62.12 / $128.88	Professional	26	$52.78	$62.12	$128.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.11 / $244.97 / $285.48	Professional	TC	$154.11	$244.97	$285.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.53 / $159.30 / $416.55	Professional		$142.53	$159.30	$416.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.25 / $53.92 / $109.88	Professional	26	$48.25	$53.92	$109.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.28 / $105.38 / $311.42	Professional	TC	$94.28	$105.38	$311.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,027.65 / $1,027.65 / $1,193.83	Professional		$1,027.65	$1,027.65	$1,193.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $463.35 / $463.35 / $463.35	Professional	26	$463.35	$463.35	$463.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $564.29 / $564.29 / $730.49	Professional	TC	$564.29	$564.29	$730.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $183.60 / $291.52 / $411.77	Professional		$183.60	$291.52	$411.77
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.26 / $105.09 / $122.79	Professional	26	$91.26	$105.09	$122.79
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $183.60 / $211.41 / $247.02	Professional	TC	$183.60	$211.41	$247.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $103.60 / $269.29	Professional		$32.34	$103.60	$269.29
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 $302.77 / $356.20 / $411.77	Professional		$302.77	$356.20	$411.77
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $99.57 / $117.14 / $141.13	Professional	26	$99.57	$117.14	$141.13
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $203.21 / $239.07 / $270.63	Professional	TC	$203.21	$239.07	$270.63
United Facility/Professional Professional Modifier Low / Median / High Price $169.02 / $248.52 / $523.66	Professional		$169.02	$248.52	$523.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.63 / $65.75 / $124.14	Professional	26	$50.63	$65.75	$124.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.95 / $196.55 / $346.88	Professional	TC	$115.95	$196.55	$346.88