Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.71 / $92.71 / $111.64	Facility	26	$92.71	$92.71	$111.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.68 / $162.05 / $235.28	Professional		$109.68	$162.05	$235.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.74 / $179.70 / $219.32	Professional		$115.74	$179.70	$219.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $567.16 / $567.16 / $629.60	Professional		$567.16	$567.16	$629.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $303.29 / $303.29 / $366.84	Professional	26	$303.29	$303.29	$366.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $177.72 / $204.65 / $270.52	Professional		$177.72	$204.65	$270.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $69.77 / $174.37	Professional		$32.34	$69.77	$174.37
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,387.45 / $1,387.45 / $1,387.45	Facility	26	$1,387.45	$1,387.45	$1,387.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $195.64 / $230.16 / $270.52	Professional		$195.64	$230.16	$270.52
United Facility/Professional Professional Modifier Low / Median / High Price $113.32 / $139.88 / $260.55	Professional		$113.32	$139.88	$260.55