Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $220.00 / $220.00 / $220.00	Facility	26	$220.00	$220.00	$220.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $456.98 / $475.00 / $1,062.31	Professional		$456.98	$475.00	$1,062.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.94 / $140.00 / $269.89	Professional	26	$95.94	$140.00	$269.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $361.04 / $792.41	Professional	TC	$335.00	$361.04	$792.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.02 / $326.38 / $742.10	Professional		$292.02	$326.38	$742.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.22 / $79.59 / $161.31	Professional	26	$71.22	$79.59	$161.31
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $507.23 / $507.23	Professional	50	$507.23	$507.23	$507.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.81 / $246.78 / $594.37	Professional	TC	$220.81	$246.78	$594.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.90 / $1,548.90 / $1,719.43	Professional		$1,548.90	$1,548.90	$1,719.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $465.52 / $465.52 / $563.05	Professional	26	$465.52	$465.52	$563.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $985.84 / $985.84 / $1,253.91	Professional	TC	$985.84	$985.84	$1,253.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $547.05 / $629.95 / $817.85	Professional		$547.05	$629.95	$817.85
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.56 / $156.10 / $182.40	Professional	26	$135.56	$156.10	$182.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $411.49 / $473.84 / $553.65	Professional	TC	$411.49	$473.84	$553.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $153.21 / $532.77	Professional		$32.34	$153.21	$532.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $603.21 / $709.66 / $817.84	Professional		$603.21	$709.66	$817.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $146.72 / $172.62 / $208.15	Professional	26	$146.72	$172.62	$208.15
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $456.48 / $537.04 / $609.69	Professional	TC	$456.48	$537.04	$609.69
United Facility/Professional Professional Modifier Low / Median / High Price $333.75 / $445.26 / $892.62	Professional		$333.75	$445.26	$892.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.23 / $92.03 / $174.20	Professional	26	$75.23	$92.03	$174.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.52 / $370.03 / $779.78	Professional	TC	$255.52	$370.03	$779.78