Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $150.33 / $393.94 / $397.25	Facility	26	$150.33	$393.94	$397.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $522.50 / $1,079.92	Professional		$425.00	$522.50	$1,079.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.34 / $154.00 / $348.00	Professional	26	$107.34	$154.00	$348.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $748.87	Professional	TC	$335.00	$368.50	$748.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.41 / $331.28 / $976.42	Professional		$296.41	$331.28	$976.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.03 / $97.27 / $197.59	Professional	26	$87.03	$97.27	$197.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.38 / $234.01 / $709.55	Professional	TC	$209.38	$234.01	$709.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,418.56 / $2,418.56 / $3,212.57	Professional		$2,418.56	$2,418.56	$3,212.57
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $857.15 / $857.15 / $858.90	Professional	26	$857.15	$857.15	$858.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,559.66 / $1,559.66 / $2,355.42	Professional	TC	$1,559.66	$1,559.66	$2,355.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $546.53 / $629.34 / $827.10	Professional		$546.53	$629.34	$827.10
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.99 / $191.14 / $223.33	Professional	26	$165.99	$191.14	$223.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $380.54 / $438.20 / $512.00	Professional	TC	$380.54	$438.20	$512.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $187.49 / $533.98	Professional		$32.34	$187.49	$533.98
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 $572.28 / $711.72 / $827.10	Professional		$572.28	$711.72	$827.10
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $179.33 / $210.98 / $254.32	Professional	26	$179.33	$210.98	$254.32
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $425.63 / $500.74 / $572.78	Professional	TC	$425.63	$500.74	$572.78
United Facility/Professional Professional Modifier Low / Median / High Price $337.13 / $573.44 / $1,209.03	Professional		$337.13	$573.44	$1,209.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.17 / $117.80 / $210.80	Professional	26	$93.17	$117.80	$210.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.03 / $455.58 / $1,006.73	Professional	TC	$242.03	$455.58	$1,006.73