Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.94 / $147.94 / $147.94	Facility	26	$147.94	$147.94	$147.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.02 / $393.43 / $431.17	Professional		$254.02	$393.43	$431.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $64.64 / $128.88	Professional	26	$52.78	$64.64	$128.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $189.38 / $302.29 / $344.61	Professional	TC	$189.38	$302.29	$344.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.86 / $183.14 / $510.00	Professional		$163.86	$183.14	$510.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.99 / $53.63 / $109.29	Professional	26	$47.99	$53.63	$109.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.87 / $129.50 / $410.70	Professional	TC	$115.87	$129.50	$410.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,124.88 / $1,124.88 / $1,248.72	Professional		$1,124.88	$1,124.88	$1,248.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $382.64 / $382.64 / $462.82	Professional	26	$382.64	$382.64	$462.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $662.06 / $662.06 / $866.08	Professional	TC	$662.06	$662.06	$866.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $317.02 / $365.07 / $474.82	Professional		$317.02	$365.07	$474.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $90.73 / $104.48 / $122.08	Professional	26	$90.73	$104.48	$122.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.30 / $260.58 / $304.47	Professional	TC	$226.30	$260.58	$304.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $92.47 / $345.31	Professional		$32.34	$92.47	$345.31
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 $349.94 / $411.69 / $474.82	Professional		$349.94	$411.69	$474.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $98.98 / $116.45 / $140.37	Professional	26	$98.98	$116.45	$140.37
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $250.95 / $295.23 / $334.45	Professional	TC	$250.95	$295.23	$334.45
United Facility/Professional Professional Modifier Low / Median / High Price $201.24 / $310.44 / $622.33	Professional		$201.24	$310.44	$622.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.64 / $65.18 / $124.14	Professional	26	$50.64	$65.18	$124.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.47 / $259.80 / $520.82	Professional	TC	$148.47	$259.80	$520.82