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 $425.00 / $522.50 / $1,239.51	Professional		$425.00	$522.50	$1,239.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.04 / $154.00 / $323.43	Professional	26	$108.04	$154.00	$323.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $410.53 / $916.08	Professional	TC	$335.00	$410.53	$916.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $341.75 / $381.95 / $938.98	Professional		$341.75	$381.95	$938.98
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 $256.45 / $286.63 / $791.06	Professional	TC	$256.45	$286.63	$791.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,363.19 / $2,363.19 / $2,623.37	Professional		$2,363.19	$2,363.19	$2,623.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $826.38 / $826.38 / $828.08	Professional	26	$826.38	$826.38	$828.08
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,535.12 / $1,535.12 / $1,796.99	Professional	TC	$1,535.12	$1,535.12	$1,796.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $622.84 / $717.21 / $946.58	Professional		$622.84	$717.21	$946.58
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 $460.07 / $529.78 / $619.00	Professional	TC	$460.07	$529.78	$619.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $164.92 / $676.61	Professional		$32.34	$164.92	$676.61
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 $656.82 / $815.15 / $946.59	Professional		$656.82	$815.15	$946.59
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $175.84 / $206.87 / $249.24	Professional	26	$175.84	$206.87	$249.24
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $517.04 / $608.28 / $697.34	Professional	TC	$517.04	$608.28	$697.34
United Facility/Professional Professional Modifier Low / Median / High Price $389.59 / $539.00 / $1,136.43	Professional		$389.59	$539.00	$1,136.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.83 / $109.71 / $206.72	Professional	26	$88.83	$109.71	$206.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $296.33 / $492.54 / $936.40	Professional	TC	$296.33	$492.54	$936.40