Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.18 / $253.18 / $408.00	Facility		$253.18	$253.18	$408.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.65 / $38.65 / $38.97	Facility	26	$38.65	$38.65	$38.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $122.51 / $212.76	Professional		$81.59	$122.51	$212.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.19 / $17.12 / $37.03	Professional	26	$14.19	$17.12	$37.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $88.54 / $180.28	Professional	TC	$67.40	$88.54	$180.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $314.62 / $776.70 / $1,344.59	Facility		$314.62	$776.70	$1,344.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $153.46 / $191.30	Professional		$87.00	$153.46	$191.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.53 / $25.54 / $30.05	Professional	26	$18.53	$25.54	$30.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.42 / $124.97 / $157.13	Professional	TC	$68.42	$124.97	$157.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $295.73 / $295.73 / $328.29	Professional		$295.73	$295.73	$328.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.91 / $78.91 / $86.50	Professional	26	$78.91	$78.91	$86.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $216.82 / $216.82 / $241.79	Professional	TC	$216.82	$216.82	$241.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.74 / $173.16 / $225.53	Facility		$87.74	$173.16	$225.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.24 / $186.83 / $218.29	Professional		$162.24	$186.83	$218.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $28.27 / $33.03	Professional	26	$24.55	$28.27	$33.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $137.69 / $146.04 / $166.90	Professional	TC	$137.69	$146.04	$166.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.11 / $32.34 / $157.47	Professional		$25.11	$32.34	$157.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $446.45 / $586.01 / $901.85	Facility		$446.45	$586.01	$901.85
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 $181.66 / $213.72 / $244.45	Professional		$181.66	$213.72	$244.45
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $31.51 / $38.02	Professional	26	$26.78	$31.51	$38.02
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $182.21 / $206.44	Professional	TC	$154.88	$182.21	$206.44
United Facility/Professional Professional Modifier Low / Median / High Price $90.20 / $104.12 / $186.33	Professional		$90.20	$104.12	$186.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.00 / $17.48 / $31.28	Professional	26	$16.00	$17.48	$31.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.20 / $86.64 / $149.97	Professional	TC	$74.20	$86.64	$149.97