Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $148.76 / $148.76 / $148.76	Facility	26	$148.76	$148.76	$148.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.33 / $415.33 / $494.41	Professional		$282.33	$415.33	$494.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $65.06 / $128.88	Professional	26	$52.46	$65.06	$128.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.28 / $345.83 / $365.54	Professional	TC	$217.28	$345.83	$365.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.18 / $239.38 / $505.29	Professional		$214.18	$239.38	$505.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.25 / $53.92 / $109.29	Professional	26	$48.25	$53.92	$109.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.94 / $185.46 / $405.93	Professional	TC	$165.94	$185.46	$405.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,072.21 / $1,072.21 / $1,190.26	Professional		$1,072.21	$1,072.21	$1,190.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $336.79 / $336.79 / $407.36	Professional	26	$336.79	$336.79	$407.36
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $664.85 / $664.85 / $853.47	Professional	TC	$664.85	$664.85	$853.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $406.69 / $468.31 / $617.83	Professional		$406.69	$468.31	$617.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.26 / $105.09 / $122.79	Professional	26	$91.26	$105.09	$122.79
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $315.43 / $363.22 / $424.40	Professional	TC	$315.43	$363.22	$424.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $103.60 / $375.17	Professional		$32.34	$103.60	$375.17
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 $428.52 / $532.92 / $617.83	Professional		$428.52	$532.92	$617.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $98.98 / $116.45 / $141.13	Professional	26	$98.98	$116.45	$141.13
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $350.00 / $416.48 / $476.69	Professional	TC	$350.00	$416.48	$476.69
United Facility/Professional Professional Modifier Low / Median / High Price $234.98 / $302.05 / $630.42	Professional		$234.98	$302.05	$630.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.64 / $65.73 / $122.51	Professional	26	$50.64	$65.73	$122.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.91 / $256.81 / $504.01	Professional	TC	$181.91	$256.81	$504.01