Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.03 / $244.58 / $256.91	Facility	26	$93.03	$244.58	$256.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.07 / $522.50 / $1,006.86	Professional		$240.07	$522.50	$1,006.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $301.27	Professional	26	$85.00	$140.00	$301.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $475.00 / $475.00 / $475.00	Professional	50	$475.00	$475.00	$475.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $134.57 / $301.50 / $319.91	Professional	52	$134.57	$301.50	$319.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $196.46 / $335.00 / $495.10	Professional	TC	$196.46	$335.00	$495.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.94 / $194.41 / $517.13	Professional		$173.94	$194.41	$517.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.79 / $60.11 / $122.40	Professional	26	$53.79	$60.11	$122.40
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $301.29 / $301.29 / $301.29	Professional	50	$301.29	$301.29	$301.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.16 / $134.29 / $412.42	Professional	TC	$120.16	$134.29	$412.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,431.42 / $1,431.42 / $2,027.01	Professional		$1,431.42	$1,431.42	$2,027.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $369.11 / $369.11 / $532.19	Professional	26	$369.11	$369.11	$532.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $899.23 / $899.23 / $1,657.90	Professional	TC	$899.23	$899.23	$1,657.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $330.36 / $380.42 / $494.08	Professional		$330.36	$380.42	$494.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.94 / $117.38 / $137.15	Professional	26	$101.94	$117.38	$137.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $228.43 / $263.04 / $307.33	Professional	TC	$228.43	$263.04	$307.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $115.54 / $322.91	Professional		$32.34	$115.54	$322.91
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 $363.91 / $428.13 / $494.08	Professional		$363.91	$428.13	$494.08
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $111.21 / $130.84 / $157.32	Professional	26	$111.21	$130.84	$157.32
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $252.70 / $297.29 / $336.75	Professional	TC	$252.70	$297.29	$336.75
United Facility/Professional Professional Modifier Low / Median / High Price $197.56 / $395.79 / $789.74	Professional		$197.56	$395.79	$789.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.00 / $72.95 / $130.56	Professional	26	$57.00	$72.95	$130.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $268.39 / $462.38	Professional	TC	$138.66	$268.39	$462.38