Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $163.04 / $299.72 / $299.72	Facility	26	$163.04	$299.72	$299.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.52 / $384.45 / $617.04	Professional		$335.52	$384.45	$617.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.31 / $127.38 / $251.87	Professional	26	$100.31	$127.38	$251.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $216.86 / $285.00 / $373.84	Professional	TC	$216.86	$285.00	$373.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.61 / $346.03 / $731.96	Professional		$309.61	$346.03	$731.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.53 / $105.65 / $212.86	Professional	26	$94.53	$105.65	$212.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.08 / $240.39 / $495.77	Professional	TC	$215.08	$240.39	$495.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,438.17 / $1,438.17 / $2,049.44	Professional		$1,438.17	$1,438.17	$2,049.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $490.18 / $490.18 / $893.84	Professional	26	$490.18	$490.18	$893.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $544.33 / $544.33 / $544.33	Professional	TC	$544.33	$544.33	$544.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $525.17 / $604.75 / $779.74	Professional		$525.17	$604.75	$779.74
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $179.87 / $190.77 / $218.02	Professional	26	$179.87	$190.77	$218.02
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $345.31 / $366.24 / $418.56	Professional	TC	$345.31	$366.24	$418.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $182.68 / $455.45	Professional		$32.34	$182.68	$455.45
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $346.39	Facility	26	$346.39	$346.39	$346.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $576.42 / $678.15 / $779.74	Professional		$576.42	$678.15	$779.74
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $194.47 / $228.79 / $276.14	Professional	26	$194.47	$228.79	$276.14
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $381.96 / $449.36 / $503.59	Professional	TC	$381.96	$449.36	$503.59
United Facility/Professional Professional Modifier Low / Median / High Price $310.75 / $394.63 / $769.61	Professional		$310.75	$394.63	$769.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.64 / $128.13 / $230.54	Professional	26	$96.64	$128.13	$230.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $207.98 / $297.99 / $648.88	Professional	TC	$207.98	$297.99	$648.88