Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.73 / $160.55 / $160.55	Facility	26	$86.73	$160.55	$160.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $285.19 / $366.46 / $500.83	Professional		$285.19	$366.46	$500.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $76.50 / $153.80	Professional	26	$54.86	$76.50	$153.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.43 / $285.00 / $365.90	Professional	TC	$217.43	$285.00	$365.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.29 / $219.39 / $450.05	Professional		$196.29	$219.39	$450.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.25 / $56.16 / $114.38	Professional	26	$50.25	$56.16	$114.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.05 / $163.22 / $347.32	Professional	TC	$146.05	$163.22	$347.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $910.16 / $910.16 / $1,010.37	Professional		$910.16	$910.16	$1,010.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $480.82 / $480.82 / $480.82	Professional	26	$480.82	$480.82	$480.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $429.34 / $429.34 / $529.54	Professional	TC	$429.34	$429.34	$529.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $374.67 / $431.43 / $571.00	Professional		$374.67	$431.43	$571.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.54 / $110.01 / $128.54	Professional	26	$95.54	$110.01	$128.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $279.13 / $321.42 / $375.56	Professional	TC	$279.13	$321.42	$375.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $108.21 / $365.40	Professional		$32.34	$108.21	$365.40
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $346.39	Facility	26	$346.39	$346.39	$346.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $396.23 / $491.83 / $571.00	Professional		$396.23	$491.83	$571.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $104.23 / $122.62 / $147.36	Professional	26	$104.23	$122.62	$147.36
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $313.83 / $369.22 / $423.64	Professional	TC	$313.83	$369.22	$423.64
United Facility/Professional Professional Modifier Low / Median / High Price $213.50 / $269.07 / $526.38	Professional		$213.50	$269.07	$526.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.66 / $78.39 / $129.87	Professional	26	$52.66	$78.39	$129.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.97 / $223.03 / $433.84	Professional	TC	$157.97	$223.03	$433.84