Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $294.33 / $294.33 / $294.33	Facility	26	$294.33	$294.33	$294.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.37 / $342.39 / $477.02	Professional		$261.37	$342.39	$477.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.00 / $128.50 / $253.59	Professional	26	$86.00	$128.50	$253.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.86 / $206.71 / $223.43	Professional	TC	$132.86	$206.71	$223.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.41 / $408.40 / $839.01	Professional		$365.41	$408.40	$839.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.17 / $106.37 / $215.93	Professional	26	$95.17	$106.37	$215.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $270.24 / $297.63 / $619.59	Professional	TC	$270.24	$297.63	$619.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,074.91 / $1,074.91 / $1,193.25	Professional		$1,074.91	$1,074.91	$1,193.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $424.43 / $424.43 / $424.43	Professional	26	$424.43	$424.43	$424.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $650.48 / $650.48 / $650.48	Professional	TC	$650.48	$650.48	$650.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $667.14 / $768.23 / $947.14	Professional		$667.14	$768.23	$947.14
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $181.47 / $192.47 / $219.96	Professional	26	$181.47	$192.47	$219.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $485.68 / $515.11 / $588.70	Professional	TC	$485.68	$515.11	$588.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $149.54 / $393.14	Professional		$32.34	$149.54	$393.14
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $742.95 / $874.06 / $1,019.24	Professional		$742.95	$874.06	$1,019.24
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $195.64 / $230.16 / $278.07	Professional	26	$195.64	$230.16	$278.07
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $547.32 / $643.90 / $741.17	Professional	TC	$547.32	$643.90	$741.17
United Facility/Professional Professional Modifier Low / Median / High Price $412.28 / $510.71 / $1,001.70	Professional		$412.28	$510.71	$1,001.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.50 / $121.77 / $231.19	Professional	26	$97.50	$121.77	$231.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $307.98 / $380.45 / $759.46	Professional	TC	$307.98	$380.45	$759.46