Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.21 / $236.46 / $236.46	Facility	26	$128.21	$236.46	$236.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.30 / $438.27 / $563.89	Professional		$317.30	$438.27	$563.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.39 / $96.23 / $198.71	Professional	26	$82.39	$96.23	$198.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.13 / $350.77 / $385.85	Professional	TC	$217.13	$350.77	$385.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $273.85 / $306.07 / $641.45	Professional		$273.85	$306.07	$641.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.37 / $83.12 / $169.32	Professional	26	$74.37	$83.12	$169.32
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $458.57 / $458.57 / $458.57	Professional	50	$458.57	$458.57	$458.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.48 / $222.95 / $488.40	Professional	TC	$199.48	$222.95	$488.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,137.03 / $1,137.03 / $1,262.21	Professional		$1,137.03	$1,137.03	$1,262.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $394.15 / $394.15 / $401.92	Professional	26	$394.15	$394.15	$401.92
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $735.11 / $735.11 / $868.06	Professional	TC	$735.11	$735.11	$868.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $524.65 / $604.14 / $787.06	Professional		$524.65	$604.14	$787.06
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $141.97 / $163.47 / $191.01	Professional	26	$141.97	$163.47	$191.01
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $382.67 / $440.65 / $514.86	Professional	TC	$382.67	$440.65	$514.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $160.54 / $474.71	Professional		$32.34	$160.54	$474.71
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 $547.50 / $680.89 / $787.06	Professional		$547.50	$680.89	$787.06
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $153.71 / $180.84 / $218.12	Professional	26	$153.71	$180.84	$218.12
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $402.08 / $500.05 / $568.94	Professional	TC	$402.08	$500.05	$568.94
United Facility/Professional Professional Modifier Low / Median / High Price $306.77 / $383.06 / $767.92	Professional		$306.77	$383.06	$767.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.98 / $101.08 / $192.00	Professional	26	$78.98	$101.08	$192.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.17 / $304.08 / $609.58	Professional	TC	$225.17	$304.08	$609.58