Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.34 / $146.09 / $146.09	Facility	26	$79.34	$146.09	$146.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.96 / $307.42 / $369.13	Professional		$216.96	$307.42	$369.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $62.00 / $122.77	Professional	26	$50.07	$62.00	$122.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.96 / $246.36 / $280.85	Professional	TC	$154.96	$246.36	$280.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $157.31 / $410.00	Professional		$140.75	$157.31	$410.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $51.35 / $104.72	Professional	26	$45.95	$51.35	$104.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.80 / $105.96 / $313.43	Professional	TC	$94.80	$105.96	$313.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $722.46 / $722.46 / $802.00	Professional		$722.46	$722.46	$802.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $440.87 / $440.87 / $441.78	Professional	26	$440.87	$440.87	$441.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.58 / $281.58 / $360.22	Professional	TC	$281.58	$281.58	$360.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $270.60 / $311.60 / $405.83	Professional		$270.60	$311.60	$405.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.99 / $100.17 / $117.04	Professional	26	$86.99	$100.17	$117.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $183.60 / $211.41 / $247.02	Professional	TC	$183.60	$211.41	$247.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $88.55 / $234.59	Professional		$32.34	$88.55	$234.59
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $346.39	Facility	26	$346.39	$346.39	$346.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $298.70 / $351.41 / $405.84	Professional		$298.70	$351.41	$405.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $94.90 / $111.65 / $134.44	Professional	26	$94.90	$111.65	$134.44
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $203.79 / $239.75 / $271.39	Professional	TC	$203.79	$239.75	$271.39
United Facility/Professional Professional Modifier Low / Median / High Price $167.19 / $244.48 / $490.10	Professional		$167.19	$244.48	$490.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.33 / $59.19 / $118.40	Professional	26	$48.33	$59.19	$118.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.88 / $196.15 / $393.23	Professional	TC	$116.88	$196.15	$393.23