Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $316.14 / $462.95 / $462.95	Facility	26	$316.14	$462.95	$462.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,176.55	Professional		$475.00	$522.50	$1,176.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.61 / $154.00 / $395.04	Professional	26	$128.61	$154.00	$395.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $360.49 / $787.51	Professional	TC	$335.00	$360.49	$787.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $322.95 / $360.96 / $813.49	Professional		$322.95	$360.96	$813.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.40 / $114.45 / $230.26	Professional	26	$102.40	$114.45	$230.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.56 / $246.51 / $608.70	Professional	TC	$220.56	$246.51	$608.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,356.44 / $2,356.44 / $2,615.87	Professional		$2,356.44	$2,356.44	$2,615.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $995.55 / $995.55 / $995.55	Professional	26	$995.55	$995.55	$995.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,360.89 / $1,360.89 / $1,360.89	Professional	TC	$1,360.89	$1,360.89	$1,360.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $585.49 / $674.20 / $893.85	Professional		$585.49	$674.20	$893.85
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $194.27 / $223.71 / $261.38	Professional	26	$194.27	$223.71	$261.38
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $391.22 / $450.49 / $526.36	Professional	TC	$391.22	$450.49	$526.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $220.17 / $573.58	Professional		$32.34	$220.17	$573.58
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 $652.71 / $767.89 / $893.85	Professional		$652.71	$767.89	$893.85
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $210.20 / $247.29 / $298.75	Professional	26	$210.20	$247.29	$298.75
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $442.51 / $520.60 / $595.09	Professional	TC	$442.51	$520.60	$595.09
United Facility/Professional Professional Modifier Low / Median / High Price $362.59 / $511.90 / $952.94	Professional		$362.59	$511.90	$952.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.49 / $136.88 / $245.47	Professional	26	$108.49	$136.88	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.85 / $366.86 / $735.44	Professional	TC	$251.85	$366.86	$735.44