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 $259.73 / $522.50 / $922.02	Professional		$259.73	$522.50	$922.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $140.00 / $237.00	Professional	26	$73.00	$140.00	$237.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $126.84 / $301.50 / $304.49	Professional	52	$126.84	$301.50	$304.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.51 / $335.00 / $438.70	Professional	TC	$174.51	$335.00	$438.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.45 / $184.92 / $556.91	Professional		$165.45	$184.92	$556.91
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 $106.77 / $119.33 / $383.63	Professional	TC	$106.77	$119.33	$383.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,485.44 / $1,485.44 / $1,888.60	Professional		$1,485.44	$1,485.44	$1,888.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $292.45 / $292.45 / $581.51	Professional	26	$292.45	$292.45	$581.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $903.93 / $903.93 / $1,596.14	Professional	TC	$903.93	$903.93	$1,596.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $310.63 / $357.69 / $467.97	Professional		$310.63	$357.69	$467.97
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 $199.07 / $229.24 / $267.83	Professional	TC	$199.07	$229.24	$267.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $126.32 / $304.57	Professional		$32.34	$126.32	$304.57
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 $343.53 / $404.15 / $467.97	Professional		$343.53	$404.15	$467.97
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $121.69 / $143.16 / $171.97	Professional	26	$121.69	$143.16	$171.97
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $221.84 / $260.99 / $296.00	Professional	TC	$221.84	$260.99	$296.00
United Facility/Professional Professional Modifier Low / Median / High Price $187.74 / $359.49 / $774.09	Professional		$187.74	$359.49	$774.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.91 / $80.18 / $143.47	Professional	26	$61.91	$80.18	$143.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.01 / $231.55 / $643.54	Professional	TC	$123.01	$231.55	$643.54