Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $150.33 / $392.77 / $396.07	Facility	26	$150.33	$392.77	$396.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $460.52 / $522.50 / $1,081.90	Professional		$460.52	$522.50	$1,081.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.00 / $154.00 / $348.00	Professional	26	$104.00	$154.00	$348.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $751.84	Professional	TC	$335.00	$348.53	$751.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.93 / $331.86 / $978.12	Professional		$296.93	$331.86	$978.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.03 / $97.27 / $197.59	Professional	26	$87.03	$97.27	$197.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.90 / $234.59 / $712.66	Professional	TC	$209.90	$234.59	$712.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,732.76 / $1,732.76 / $2,413.16	Professional		$1,732.76	$1,732.76	$2,413.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $858.90 / $858.90 / $858.90	Professional	26	$858.90	$858.90	$858.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $873.86 / $873.86 / $1,554.26	Professional	TC	$873.86	$873.86	$1,554.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $548.66 / $631.79 / $830.18	Professional		$548.66	$631.79	$830.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.99 / $191.14 / $223.33	Professional	26	$165.99	$191.14	$223.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $382.67 / $440.65 / $514.86	Professional	TC	$382.67	$440.65	$514.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $149.03 / $597.29	Professional		$32.34	$149.03	$597.29
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 $574.48 / $714.46 / $830.18	Professional		$574.48	$714.46	$830.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $179.33 / $210.98 / $254.32	Professional	26	$179.33	$210.98	$254.32
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $427.96 / $503.48 / $575.86	Professional	TC	$427.96	$503.48	$575.86
United Facility/Professional Professional Modifier Low / Median / High Price $337.75 / $574.88 / $1,152.78	Professional		$337.75	$574.88	$1,152.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.16 / $117.80 / $210.81	Professional	26	$93.16	$117.80	$210.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.65 / $481.72 / $1,011.03	Professional	TC	$242.65	$481.72	$1,011.03