Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $211.01 / $211.01 / $211.01	Facility	26	$211.01	$211.01	$211.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $414.87 / $494.18 / $965.14	Professional		$414.87	$494.18	$965.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.11 / $140.00 / $260.74	Professional	26	$87.11	$140.00	$260.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $322.24 / $348.53 / $704.40	Professional	TC	$322.24	$348.53	$704.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.70 / $296.95 / $811.16	Professional		$265.70	$296.95	$811.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.55 / $76.61 / $155.94	Professional	26	$68.55	$76.61	$155.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.15 / $220.34 / $661.61	Professional	TC	$197.15	$220.34	$661.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,571.86 / $1,571.86 / $1,744.91	Professional		$1,571.86	$1,571.86	$1,744.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $620.65 / $620.65 / $677.05	Professional	26	$620.65	$620.65	$677.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $951.21 / $951.21 / $1,067.85	Professional	TC	$951.21	$951.21	$1,067.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $490.48 / $564.79 / $740.90	Professional		$490.48	$564.79	$740.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $129.69 / $149.34 / $174.49	Professional	26	$129.69	$149.34	$174.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $360.79 / $415.45 / $485.43	Professional	TC	$360.79	$415.45	$485.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $146.94 / $478.57	Professional		$32.34	$146.94	$478.57
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 $543.24 / $639.11 / $740.89	Professional		$543.24	$639.11	$740.89
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $140.90 / $165.77 / $200.40	Professional	26	$140.90	$165.77	$200.40
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $402.34 / $473.34 / $540.49	Professional	TC	$402.34	$473.34	$540.49
United Facility/Professional Professional Modifier Low / Median / High Price $303.70 / $497.05 / $1,047.99	Professional		$303.70	$497.05	$1,047.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.76 / $93.48 / $167.28	Professional	26	$71.76	$93.48	$167.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.23 / $425.29 / $852.60	Professional	TC	$228.23	$425.29	$852.60