Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $219.10 / $225.50 / $225.50	Facility	26	$219.10	$225.50	$225.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.00 / $434.02 / $555.73	Professional		$313.00	$434.02	$555.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.34 / $91.56 / $189.50	Professional	26	$78.34	$91.56	$189.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.00 / $350.78 / $385.85	Professional	TC	$217.00	$350.78	$385.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.07 / $285.07 / $611.54	Professional		$255.07	$285.07	$611.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.18 / $79.55 / $161.58	Professional	26	$71.18	$79.55	$161.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.88 / $205.52 / $485.65	Professional	TC	$183.88	$205.52	$485.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,297.73 / $1,297.73 / $1,440.60	Professional		$1,297.73	$1,297.73	$1,440.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $474.33 / $474.33 / $573.72	Professional	26	$474.33	$474.33	$573.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $724.01 / $724.01 / $966.27	Professional	TC	$724.01	$724.01	$966.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $494.75 / $569.72 / $742.40	Professional		$494.75	$569.72	$742.40
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 $359.73 / $414.24 / $484.00	Professional	TC	$359.73	$414.24	$484.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $145.13 / $419.13	Professional		$32.34	$145.13	$419.13
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 $516.10 / $641.84 / $742.40	Professional		$516.10	$641.84	$742.40
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $146.15 / $171.94 / $207.29	Professional	26	$146.15	$171.94	$207.29
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $377.85 / $469.91 / $535.11	Professional	TC	$377.85	$469.91	$535.11
United Facility/Professional Professional Modifier Low / Median / High Price $278.54 / $390.87 / $783.58	Professional		$278.54	$390.87	$783.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.51 / $91.67 / $172.72	Professional	26	$75.51	$91.67	$172.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.62 / $315.36 / $637.77	Professional	TC	$200.62	$315.36	$637.77