Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.39 / $176.52 / $178.00	Facility	26	$95.39	$176.52	$178.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $291.81 / $415.86 / $513.87	Professional		$291.81	$415.86	$513.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $74.53 / $148.34	Professional	26	$60.39	$74.53	$148.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.28 / $346.55 / $381.20	Professional	TC	$217.28	$346.55	$381.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.69 / $246.65 / $582.00	Professional		$220.69	$246.65	$582.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.27 / $61.77 / $125.70	Professional	26	$55.27	$61.77	$125.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.42 / $184.88 / $469.44	Professional	TC	$165.42	$184.88	$469.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $695.11 / $695.11 / $1,072.21	Professional		$695.11	$695.11	$1,072.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $528.02 / $528.02 / $529.11	Professional	26	$528.02	$528.02	$529.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.09 / $167.09 / $543.10	Professional	TC	$167.09	$167.09	$543.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $421.10 / $484.90 / $640.63	Professional		$421.10	$484.90	$640.63
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.61 / $120.46 / $140.75	Professional	26	$104.61	$120.46	$140.75
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $316.49 / $364.44 / $425.82	Professional	TC	$316.49	$364.44	$425.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $118.70 / $388.69	Professional		$32.34	$118.70	$388.69
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 $444.50 / $552.79 / $640.62	Professional		$444.50	$552.79	$640.62
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $114.12 / $134.26 / $161.63	Professional	26	$114.12	$134.26	$161.63
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $350.00 / $418.54 / $478.99	Professional	TC	$350.00	$418.54	$478.99
United Facility/Professional Professional Modifier Low / Median / High Price $240.81 / $356.44 / $659.51	Professional		$240.81	$356.44	$659.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.16 / $75.42 / $140.71	Professional	26	$58.16	$75.42	$140.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.76 / $298.27 / $543.89	Professional	TC	$179.76	$298.27	$543.89