Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.43 / $384.88 / $384.88	Facility	26	$147.43	$384.88	$384.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,079.23	Professional		$400.00	$475.00	$1,079.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.68 / $145.65 / $323.43	Professional	26	$107.68	$145.65	$323.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $755.80	Professional	TC	$335.00	$348.53	$755.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.23 / $331.08 / $951.21	Professional		$296.23	$331.08	$951.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.29 / $95.32 / $192.75	Professional	26	$85.29	$95.32	$192.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.94 / $235.75 / $715.15	Professional	TC	$210.94	$235.75	$715.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,206.58 / $1,206.58 / $2,255.16	Professional		$1,206.58	$1,206.58	$2,255.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $818.46 / $818.46 / $834.59	Professional	26	$818.46	$818.46	$834.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $388.13 / $388.13 / $1,420.57	Professional	TC	$388.13	$388.13	$1,420.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $547.05 / $629.95 / $827.41	Professional		$547.05	$629.95	$827.41
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 $384.27 / $442.49 / $517.02	Professional	TC	$384.27	$442.49	$517.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $164.92 / $595.29	Professional		$32.34	$164.92	$595.29
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 $572.83 / $712.40 / $827.41	Professional		$572.83	$712.40	$827.41
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $175.25 / $206.18 / $249.24	Professional	26	$175.25	$206.18	$249.24
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $430.29 / $506.22 / $578.16	Professional	TC	$430.29	$506.22	$578.16
United Facility/Professional Professional Modifier Low / Median / High Price $336.82 / $572.85 / $1,183.08	Professional		$336.82	$572.85	$1,183.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.83 / $115.14 / $206.04	Professional	26	$88.83	$115.14	$206.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.87 / $484.02 / $1,016.05	Professional	TC	$243.87	$484.02	$1,016.05