Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.97 / $386.05 / $386.05	Facility	26	$147.97	$386.05	$386.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.02 / $536.02 / $1,243.47	Professional		$457.02	$536.02	$1,243.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.61 / $142.38 / $324.42	Professional	26	$115.61	$142.38	$324.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $919.05	Professional	TC	$335.00	$368.50	$919.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.79 / $383.11 / $940.78	Professional		$342.79	$383.11	$940.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.55 / $95.61 / $193.35	Professional	26	$85.55	$95.61	$193.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.24 / $287.50 / $792.86	Professional	TC	$257.24	$287.50	$792.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,349.69 / $2,349.69 / $2,608.38	Professional		$2,349.69	$2,349.69	$2,608.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $732.54 / $732.54 / $732.54	Professional	26	$732.54	$732.54	$732.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,617.15 / $1,617.15 / $1,875.84	Professional	TC	$1,617.15	$1,617.15	$1,875.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $624.44 / $719.06 / $949.67	Professional		$624.44	$719.06	$949.67
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $162.79 / $187.45 / $219.03	Professional	26	$162.79	$187.45	$219.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $461.67 / $531.62 / $621.16	Professional	TC	$461.67	$531.62	$621.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $183.77 / $608.77	Professional		$32.34	$183.77	$608.77
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 $658.96 / $818.58 / $949.66	Professional		$658.96	$818.58	$949.66
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $176.42 / $207.55 / $250.01	Professional	26	$176.42	$207.55	$250.01
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $519.37 / $611.02 / $699.65	Professional	TC	$519.37	$611.02	$699.65
United Facility/Professional Professional Modifier Low / Median / High Price $390.20 / $538.41 / $1,144.03	Professional		$390.20	$538.41	$1,144.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.11 / $115.52 / $206.72	Professional	26	$89.11	$115.52	$206.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $296.95 / $449.31 / $937.11	Professional	TC	$296.95	$449.31	$937.11