Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.28 / $283.30 / $293.14	Facility	26	$112.28	$283.30	$293.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $435.03 / $522.50 / $1,003.19	Professional		$435.03	$522.50	$1,003.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.72 / $140.00 / $246.35	Professional	26	$87.72	$140.00	$246.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $756.84	Professional	TC	$335.00	$348.53	$756.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.26 / $309.88 / $711.86	Professional		$277.26	$309.88	$711.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.76 / $72.38 / $146.55	Professional	26	$64.76	$72.38	$146.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.50 / $237.50 / $577.87	Professional	TC	$212.50	$237.50	$577.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,700.15 / $1,700.15 / $2,517.88	Professional		$1,700.15	$1,700.15	$2,517.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $415.26 / $415.26 / $634.66	Professional	26	$415.26	$415.26	$634.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,065.49 / $1,065.49 / $2,102.62	Professional	TC	$1,065.49	$1,065.49	$2,102.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $504.36 / $580.77 / $766.82	Professional		$504.36	$580.77	$766.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.22 / $140.72 / $164.44	Professional	26	$122.22	$140.72	$164.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $382.14 / $440.04 / $514.15	Professional	TC	$382.14	$440.04	$514.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $138.59 / $491.63	Professional		$32.34	$138.59	$491.63
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 $563.04 / $662.40 / $766.82	Professional		$563.04	$662.40	$766.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $133.34 / $156.87 / $188.64	Professional	26	$133.34	$156.87	$188.64
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $429.70 / $505.53 / $578.17	Professional	TC	$429.70	$505.53	$578.17
United Facility/Professional Professional Modifier Low / Median / High Price $315.66 / $419.81 / $885.12	Professional		$315.66	$419.81	$885.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.42 / $83.73 / $157.77	Professional	26	$67.42	$83.73	$157.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.49 / $352.39 / $726.78	Professional	TC	$244.49	$352.39	$726.78