Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.35 / $266.73 / $268.98	Facility	26	$101.35	$266.73	$268.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.88 / $522.50 / $963.49	Professional		$322.88	$522.50	$963.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.66 / $140.00 / $255.53	Professional	26	$74.66	$140.00	$255.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $126.63 / $304.00 / $319.00	Professional	52	$126.63	$304.00	$319.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $171.55 / $335.00 / $437.57	Professional	TC	$171.55	$335.00	$437.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.19 / $184.62 / $544.15	Professional		$165.19	$184.62	$544.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.68 / $65.59 / $133.72	Professional	26	$58.68	$65.59	$133.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.51 / $119.04 / $375.00	Professional	TC	$106.51	$119.04	$375.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,435.47 / $1,435.47 / $1,829.95	Professional		$1,435.47	$1,435.47	$1,829.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $442.81 / $442.81 / $581.50	Professional	26	$442.81	$442.81	$581.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $853.97 / $853.97 / $1,387.14	Professional	TC	$853.97	$853.97	$1,387.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $309.56 / $356.46 / $466.44	Professional		$309.56	$356.46	$466.44
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $111.54 / $128.44 / $150.07	Professional	26	$111.54	$128.44	$150.07
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $198.02 / $228.02 / $266.42	Professional	TC	$198.02	$228.02	$266.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $126.32 / $303.54	Professional		$32.34	$126.32	$303.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $446.45	Facility	26	$446.45	$446.45	$446.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $342.36 / $402.78 / $466.44	Professional		$342.36	$402.78	$466.44
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $121.11 / $142.47 / $171.97	Professional	26	$121.11	$142.47	$171.97
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $221.26 / $260.30 / $294.47	Professional	TC	$221.26	$260.30	$294.47
United Facility/Professional Professional Modifier Low / Median / High Price $187.43 / $359.17 / $778.36	Professional		$187.43	$359.17	$778.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.73 / $80.18 / $152.30	Professional	26	$64.73	$80.18	$152.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.70 / $243.23 / $638.04	Professional	TC	$122.70	$243.23	$638.04