Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.85 / $218.85 / $218.85	Facility	26	$218.85	$218.85	$218.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.29 / $475.00 / $861.95	Professional		$365.29	$475.00	$861.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.74 / $140.00 / $268.36	Professional	26	$95.74	$140.00	$268.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.55 / $348.53 / $593.59	Professional	TC	$269.55	$348.53	$593.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.71 / $263.44 / $737.78	Professional		$235.71	$263.44	$737.78
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 $164.90 / $184.30 / $543.20	Professional	TC	$164.90	$184.30	$543.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,701.50 / $1,701.50 / $1,888.82	Professional		$1,701.50	$1,701.50	$1,888.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $352.69 / $352.69 / $752.88	Professional	26	$352.69	$352.69	$752.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $948.62 / $948.62 / $1,536.13	Professional	TC	$948.62	$948.62	$1,536.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $439.25 / $505.80 / $662.18	Professional		$439.25	$505.80	$662.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.04 / $155.50 / $181.68	Professional	26	$135.04	$155.50	$181.68
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $304.23 / $350.32 / $409.32	Professional	TC	$304.23	$350.32	$409.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $152.41 / $429.00	Professional		$32.34	$152.41	$429.00
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 $486.18 / $571.98 / $662.17	Professional		$486.18	$571.98	$662.17
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $146.15 / $171.94 / $207.01	Professional	26	$146.15	$171.94	$207.01
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $340.03 / $400.04 / $455.16	Professional	TC	$340.03	$400.04	$455.16
United Facility/Professional Professional Modifier Low / Median / High Price $268.11 / $456.54 / $962.57	Professional		$268.11	$456.54	$962.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.36 / $97.89 / $172.05	Professional	26	$74.36	$97.89	$172.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.49 / $346.98 / $788.61	Professional	TC	$190.49	$346.98	$788.61