Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.34 / $146.09 / $147.32	Facility	26	$79.34	$146.09	$147.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.55 / $322.50 / $488.67	Professional		$267.55	$322.50	$488.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $62.00 / $122.77	Professional	26	$50.07	$62.00	$122.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.43 / $266.89 / $365.90	Professional	TC	$217.43	$266.89	$365.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.51 / $215.16 / $441.38	Professional		$192.51	$215.16	$441.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $51.35 / $104.72	Professional	26	$45.95	$51.35	$104.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.57 / $163.81 / $328.78	Professional	TC	$146.57	$163.81	$328.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $848.05 / $848.05 / $941.41	Professional		$848.05	$848.05	$941.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $282.16 / $282.16 / $440.88	Professional	26	$282.16	$282.16	$440.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $500.53 / $500.53 / $565.89	Professional	TC	$500.53	$500.53	$565.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $368.26 / $424.06 / $560.38	Professional		$368.26	$424.06	$560.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.99 / $100.17 / $117.04	Professional	26	$86.99	$100.17	$117.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.27 / $323.89 / $378.44	Professional	TC	$281.27	$323.89	$378.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $98.67 / $358.93	Professional		$32.34	$98.67	$358.93
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 $388.31 / $482.93 / $560.38	Professional		$388.31	$482.93	$560.38
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $94.90 / $111.65 / $134.44	Professional	26	$94.90	$111.65	$134.44
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $315.58 / $371.27 / $425.94	Professional	TC	$315.58	$371.27	$425.94
United Facility/Professional Professional Modifier Low / Median / High Price $208.90 / $258.77 / $512.83	Professional		$208.90	$258.77	$512.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.32 / $62.32 / $118.38	Professional	26	$48.32	$62.32	$118.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.59 / $196.46 / $407.60	Professional	TC	$158.59	$196.46	$407.60