Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.57 / $218.90 / $220.73	Facility	26	$119.57	$218.90	$220.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.50 / $235.13 / $406.68	Professional		$193.50	$235.13	$406.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.87 / $109.82 / $183.95	Professional	26	$72.87	$109.82	$183.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.64 / $150.21 / $253.91	Professional	TC	$120.64	$150.21	$253.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.54 / $172.73 / $345.43	Professional		$154.54	$172.73	$345.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.09 / $77.23 / $156.61	Professional	26	$69.09	$77.23	$156.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.44 / $95.49 / $195.89	Professional	TC	$85.44	$95.49	$195.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $872.35 / $872.35 / $1,223.31	Professional		$872.35	$872.35	$1,223.31
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $519.82 / $519.82 / $522.11	Professional	26	$519.82	$519.82	$522.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $352.53 / $352.53 / $701.20	Professional	TC	$352.53	$352.53	$701.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $298.35 / $343.56 / $448.06	Professional		$298.35	$343.56	$448.06
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $130.76 / $138.69 / $158.50	Professional	26	$130.76	$138.69	$158.50
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.59 / $177.75 / $203.14	Professional	TC	$167.59	$177.75	$203.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $142.49 / $293.83	Professional		$32.34	$142.49	$293.83
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 $327.81 / $385.66 / $448.06	Professional		$327.81	$385.66	$448.06
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $142.07 / $167.14 / $202.03	Professional	26	$142.07	$167.14	$202.03
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $185.74 / $218.52 / $246.03	Professional	TC	$185.74	$218.52	$246.03
United Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $213.93 / $419.23	Professional		$172.70	$213.93	$419.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.88 / $99.09 / $177.24	Professional	26	$70.88	$99.09	$177.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.93 / $121.52 / $243.60	Professional	TC	$96.93	$121.52	$243.60