Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.53 / $154.53 / $154.53	Facility	26	$154.53	$154.53	$154.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.41 / $371.00 / $437.55	Professional		$258.41	$371.00	$437.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $67.33 / $134.56	Professional	26	$54.56	$67.33	$134.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.08 / $287.81 / $325.76	Professional	TC	$191.08	$287.81	$325.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.90 / $186.54 / $504.07	Professional		$166.90	$186.54	$504.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.99 / $55.87 / $114.12	Professional	26	$49.99	$55.87	$114.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.91 / $130.66 / $388.29	Professional	TC	$116.91	$130.66	$388.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,030.34 / $1,030.34 / $1,143.79	Professional		$1,030.34	$1,030.34	$1,143.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $377.35 / $377.35 / $456.42	Professional	26	$377.35	$377.35	$456.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $573.92 / $573.92 / $766.44	Professional	TC	$573.92	$573.92	$766.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $319.70 / $368.14 / $481.81	Professional		$319.70	$368.14	$481.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.01 / $109.40 / $127.83	Professional	26	$95.01	$109.40	$127.83
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 / $107.62 / $312.45	Professional		$32.34	$107.62	$312.45
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 / $417.17 / $481.81	Professional		$350.00	$417.17	$481.81
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $103.64 / $121.93 / $147.36	Professional	26	$103.64	$121.93	$147.36
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $250.95 / $295.23 / $334.45	Professional	TC	$250.95	$295.23	$334.45
United Facility/Professional Professional Modifier Low / Median / High Price $197.86 / $300.60 / $634.53	Professional		$197.86	$300.60	$634.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.66 / $68.02 / $127.40	Professional	26	$52.66	$68.02	$127.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.94 / $247.94 / $497.06	Professional	TC	$142.94	$247.94	$497.06