Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.50 / $69.50 / $69.50	Facility	26	$69.50	$69.50	$69.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.26 / $166.63 / $276.52	Professional		$110.26	$166.63	$276.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.05 / $200.83 / $248.45	Professional		$106.05	$200.83	$248.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $284.93 / $284.93 / $316.30	Professional		$284.93	$284.93	$316.30
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.11 / $81.11 / $98.11	Professional	26	$81.11	$81.11	$98.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $209.75 / $241.53 / $282.20	Professional		$209.75	$241.53	$282.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $48.40 / $226.80	Professional		$32.34	$48.40	$226.80
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 $235.82 / $277.43 / $316.72	Professional		$235.82	$277.43	$316.72
United Facility/Professional Professional Modifier Low / Median / High Price $115.73 / $148.29 / $242.54	Professional		$115.73	$148.29	$242.54