Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $219.66 / $219.66 / $219.66	Facility	26	$219.66	$219.66	$219.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.24 / $494.18 / $877.78	Professional		$371.24	$494.18	$877.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.10 / $140.00 / $269.35	Professional	26	$94.10	$140.00	$269.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.50 / $348.53 / $608.42	Professional	TC	$275.50	$348.53	$608.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.35 / $267.51 / $644.04	Professional		$239.35	$267.51	$644.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $79.14 / $160.79	Professional	26	$70.81	$79.14	$160.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.54 / $188.37 / $536.92	Professional	TC	$168.54	$188.37	$536.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,688.00 / $1,688.00 / $1,873.83	Professional		$1,688.00	$1,688.00	$1,873.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $617.16 / $617.16 / $746.48	Professional	26	$617.16	$617.16	$746.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $941.52 / $941.52 / $1,256.66	Professional	TC	$941.52	$941.52	$1,256.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $447.25 / $515.01 / $673.71	Professional		$447.25	$515.01	$673.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.56 / $156.10 / $182.40	Professional	26	$135.56	$156.10	$182.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $311.69 / $358.91 / $419.36	Professional	TC	$311.69	$358.91	$419.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $137.29 / $486.60	Professional		$32.34	$137.29	$486.60
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 $494.91 / $582.25 / $673.71	Professional		$494.91	$582.25	$673.71
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $146.72 / $172.62 / $207.78	Professional	26	$146.72	$172.62	$207.78
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $348.19 / $409.63 / $465.92	Professional	TC	$348.19	$409.63	$465.92
United Facility/Professional Professional Modifier Low / Median / High Price $272.41 / $467.83 / $1,007.51	Professional		$272.41	$467.83	$1,007.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.92 / $96.25 / $172.73	Professional	26	$77.92	$96.25	$172.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.49 / $331.55 / $683.90	Professional	TC	$194.49	$331.55	$683.90