Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.38 / $261.69 / $308.85	Facility	26	$104.38	$261.69	$308.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.30 / $475.00 / $624.05	Professional		$262.30	$475.00	$624.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.59 / $140.00 / $289.50	Professional	26	$77.59	$140.00	$289.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $184.71 / $335.00 / $460.71	Professional	TC	$184.71	$335.00	$460.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.58 / $190.65 / $576.50	Professional		$170.58	$190.65	$576.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.57 / $64.34 / $131.46	Professional	26	$57.57	$64.34	$131.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.01 / $126.31 / $443.89	Professional	TC	$113.01	$126.31	$443.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,358.50 / $1,358.50 / $1,508.06	Professional		$1,358.50	$1,358.50	$1,508.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $430.35 / $430.35 / $570.21	Professional	26	$430.35	$430.35	$570.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $788.29 / $788.29 / $1,077.71	Professional	TC	$788.29	$788.29	$1,077.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $317.56 / $365.67 / $480.86	Professional		$317.56	$365.67	$480.86
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.41 / $125.99 / $147.21	Professional	26	$109.41	$125.99	$147.21
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.15 / $239.69 / $280.05	Professional	TC	$208.15	$239.69	$280.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $123.90 / $311.14	Professional		$32.34	$123.90	$311.14
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 $351.68 / $413.74 / $480.86	Professional		$351.68	$413.74	$480.86
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $119.36 / $140.41 / $169.48	Professional	26	$119.36	$140.41	$169.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $232.32 / $273.32 / $311.38	Professional	TC	$232.32	$273.32	$311.38
United Facility/Professional Professional Modifier Low / Median / High Price $194.49 / $364.83 / $769.20	Professional		$194.49	$364.83	$769.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.47 / $75.06 / $141.44	Professional	26	$60.47	$75.06	$141.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.68 / $289.67 / $623.50	Professional	TC	$130.68	$289.67	$623.50