Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.18 / $218.18 / $218.18	Facility	26	$218.18	$218.18	$218.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $494.18 / $1,067.97	Professional		$425.00	$494.18	$1,067.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.63 / $140.00 / $268.64	Professional	26	$95.63	$140.00	$268.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $363.59 / $799.33	Professional	TC	$335.00	$363.59	$799.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.25 / $327.75 / $738.90	Professional		$293.25	$327.75	$738.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.88 / $79.22 / $160.58	Professional	26	$70.88	$79.22	$160.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.37 / $248.53 / $592.63	Professional	TC	$222.37	$248.53	$592.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,662.34 / $1,662.34 / $1,845.35	Professional		$1,662.34	$1,662.34	$1,845.35
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $533.21 / $533.21 / $577.99	Professional	26	$533.21	$533.21	$577.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,084.34 / $1,084.34 / $1,312.14	Professional	TC	$1,084.34	$1,084.34	$1,312.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $547.05 / $629.95 / $822.27	Professional		$547.05	$629.95	$822.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.49 / $154.87 / $180.95	Professional	26	$134.49	$154.87	$180.95
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $412.57 / $475.08 / $555.09	Professional	TC	$412.57	$475.08	$555.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $136.36 / $471.79	Professional		$32.34	$136.36	$471.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $572.28 / $711.72 / $822.27	Professional		$572.28	$711.72	$822.27
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $145.56 / $171.25 / $207.20	Professional	26	$145.56	$171.25	$207.20
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $459.40 / $540.47 / $615.07	Professional	TC	$459.40	$540.47	$615.07
United Facility/Professional Professional Modifier Low / Median / High Price $334.68 / $443.53 / $959.89	Professional		$334.68	$443.53	$959.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.36 / $109.57 / $172.20	Professional	26	$74.36	$109.57	$172.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.07 / $369.17 / $775.02	Professional	TC	$257.07	$369.17	$775.02