Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.85 / $262.87 / $265.07	Facility	26	$99.85	$262.87	$265.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.08 / $475.00 / $836.03	Professional		$389.08	$475.00	$836.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.01 / $140.00 / $251.82	Professional	26	$78.01	$140.00	$251.82
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $155.94 / $301.50 / $366.68	Professional	52	$155.94	$301.50	$366.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $233.85 / $335.00 / $512.46	Professional	TC	$233.85	$335.00	$512.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.88 / $224.51 / $660.72	Professional		$200.88	$224.51	$660.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.83 / $64.63 / $131.46	Professional	26	$57.83	$64.63	$131.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $143.05 / $159.88 / $484.48	Professional	TC	$143.05	$159.88	$484.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,431.42 / $1,431.42 / $1,710.20	Professional		$1,431.42	$1,431.42	$1,710.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $569.03 / $569.03 / $570.20	Professional	26	$569.03	$569.03	$570.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $861.22 / $861.22 / $1,141.17	Professional	TC	$861.22	$861.22	$1,141.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $370.39 / $426.51 / $560.82	Professional		$370.39	$426.51	$560.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.94 / $126.60 / $147.91	Professional	26	$109.94	$126.60	$147.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $260.45 / $299.92 / $350.43	Professional	TC	$260.45	$299.92	$350.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $124.49 / $362.04	Professional		$32.34	$124.49	$362.04
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 $411.66 / $484.30 / $560.82	Professional		$411.66	$484.30	$560.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $119.94 / $141.11 / $169.48	Professional	26	$119.94	$141.11	$169.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $291.70 / $343.19 / $391.34	Professional	TC	$291.70	$343.19	$391.34
United Facility/Professional Professional Modifier Low / Median / High Price $229.76 / $409.67 / $821.28	Professional		$229.76	$409.67	$821.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.05 / $79.05 / $149.97	Professional	26	$61.05	$79.05	$149.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.95 / $348.62 / $698.90	Professional	TC	$165.95	$348.62	$698.90