Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $137.21 / $252.63 / $254.75	Facility	26	$137.21	$252.63	$254.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.00 / $477.43 / $764.79	Professional		$371.00	$477.43	$764.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.53 / $122.56 / $225.16	Professional	26	$84.53	$122.56	$225.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $285.00 / $361.18 / $552.49	Professional	TC	$285.00	$361.18	$552.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $289.35 / $323.39 / $663.40	Professional		$289.35	$323.39	$663.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.45 / $88.80 / $180.17	Professional	26	$79.45	$88.80	$180.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.90 / $234.59 / $481.23	Professional	TC	$209.90	$234.59	$481.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $902.10 / $902.10 / $1,462.48	Professional		$902.10	$902.10	$1,462.48
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $756.67 / $756.67 / $758.21	Professional	26	$756.67	$756.67	$758.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $145.43 / $145.43 / $704.27	Professional	TC	$145.43	$145.43	$704.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $549.20 / $632.41 / $833.45	Professional		$549.20	$632.41	$833.45
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $151.04 / $160.19 / $183.08	Professional	26	$151.04	$160.19	$183.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $398.15 / $422.28 / $482.60	Professional	TC	$398.15	$422.28	$482.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $170.92 / $536.08	Professional		$32.34	$170.92	$536.08
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 $577.24 / $717.88 / $833.45	Professional		$577.24	$717.88	$833.45
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $163.62 / $192.49 / $232.20	Professional	26	$163.62	$192.49	$232.20
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $425.06 / $525.40 / $601.25	Professional	TC	$425.06	$525.40	$601.25
United Facility/Professional Professional Modifier Low / Median / High Price $317.50 / $393.30 / $783.45	Professional		$317.50	$393.30	$783.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.17 / $115.00 / $205.23	Professional	26	$82.17	$115.00	$205.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $230.38 / $325.25 / $623.50	Professional	TC	$230.38	$325.25	$623.50