Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.13 / $241.66 / $243.69	Facility	26	$92.13	$241.66	$243.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $303.70 / $494.18 / $811.20	Professional		$303.70	$494.18	$811.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.61 / $140.00 / $231.51	Professional	26	$80.61	$140.00	$231.51
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $712.50 / $712.50 / $712.50	Professional	50	$712.50	$712.50	$712.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $231.73 / $335.00 / $508.50	Professional	TC	$231.73	$335.00	$508.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.15 / $218.11 / $642.85	Professional		$195.15	$218.11	$642.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.40 / $59.68 / $121.20	Professional	26	$53.40	$59.68	$121.20
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.09 / $338.09 / $338.09	Professional	50	$338.09	$338.09	$338.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.75 / $158.41 / $478.21	Professional	TC	$141.75	$158.41	$478.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,029.80 / $1,029.80 / $1,403.06	Professional		$1,029.80	$1,029.80	$1,403.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $283.18 / $283.18 / $526.02	Professional	26	$283.18	$283.18	$526.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $746.62 / $746.62 / $877.04	Professional	TC	$746.62	$746.62	$877.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $361.33 / $416.08 / $547.13	Professional		$361.33	$416.08	$547.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.41 / $116.77 / $136.44	Professional	26	$101.41	$116.77	$136.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.92 / $299.31 / $349.72	Professional	TC	$259.92	$299.31	$349.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $103.16 / $393.32	Professional		$32.34	$103.16	$393.32
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $446.45	Facility	26	$446.45	$446.45	$446.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $401.17 / $471.97 / $547.13	Professional		$401.17	$471.97	$547.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $110.05 / $129.47 / $156.56	Professional	26	$110.05	$129.47	$156.56
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $291.13 / $342.50 / $390.57	Professional	TC	$291.13	$342.50	$390.57
United Facility/Professional Professional Modifier Low / Median / High Price $222.40 / $401.00 / $845.46	Professional		$222.40	$401.00	$845.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $72.58 / $129.88	Professional	26	$55.84	$72.58	$129.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.81 / $345.16 / $691.94	Professional	TC	$163.81	$345.16	$691.94