Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $219.02 / $219.02 / $219.02	Facility	26	$219.02	$219.02	$219.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $429.99 / $494.18 / $1,065.99	Professional		$429.99	$494.18	$1,065.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.20 / $140.00 / $268.64	Professional	26	$95.20	$140.00	$268.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $363.17 / $797.35	Professional	TC	$335.00	$363.17	$797.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.73 / $327.17 / $733.90	Professional		$292.73	$327.17	$733.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.62 / $78.93 / $159.99	Professional	26	$70.62	$78.93	$159.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.11 / $248.24 / $579.42	Professional	TC	$222.11	$248.24	$579.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,731.21 / $1,731.21 / $1,921.80	Professional		$1,731.21	$1,731.21	$1,921.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $520.19 / $520.19 / $629.16	Professional	26	$520.19	$520.19	$629.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,102.04 / $1,102.04 / $1,401.61	Professional	TC	$1,102.04	$1,102.04	$1,401.61
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $549.73 / $633.02 / $823.81	Professional		$549.73	$633.02	$823.81
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 $414.69 / $477.53 / $557.95	Professional	TC	$414.69	$477.53	$557.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $152.53 / $535.24	Professional		$32.34	$152.53	$535.24
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $607.29 / $714.46 / $823.81	Professional		$607.29	$714.46	$823.81
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $145.56 / $171.25 / $207.20	Professional	26	$145.56	$171.25	$207.20
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $461.72 / $543.20 / $616.61	Professional	TC	$461.72	$543.20	$616.61
United Facility/Professional Professional Modifier Low / Median / High Price $333.14 / $444.11 / $890.31	Professional		$333.14	$444.11	$890.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.36 / $95.76 / $172.20	Professional	26	$74.36	$95.76	$172.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.83 / $369.75 / $741.24	Professional	TC	$255.83	$369.75	$741.24