Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.47 / $297.64 / $300.14	Facility	26	$162.47	$297.64	$300.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $344.21 / $461.45 / $615.66	Professional		$344.21	$461.45	$615.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.37 / $126.93 / $250.12	Professional	26	$104.37	$126.93	$250.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.28 / $350.63 / $385.70	Professional	TC	$217.28	$350.63	$385.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.31 / $384.82 / $789.42	Professional		$344.31	$384.82	$789.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.11 / $105.19 / $212.94	Professional	26	$94.11	$105.19	$212.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $250.20 / $279.63 / $573.64	Professional	TC	$250.20	$279.63	$573.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,492.19 / $1,492.19 / $1,656.47	Professional		$1,492.19	$1,492.19	$1,656.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $877.80 / $877.80 / $895.08	Professional	26	$877.80	$877.80	$895.08
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $614.39 / $614.39 / $761.39	Professional	TC	$614.39	$614.39	$761.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $667.67 / $768.84 / $994.64	Professional		$667.67	$768.84	$994.64
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $178.27 / $205.28 / $239.85	Professional	26	$178.27	$205.28	$239.85
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $489.42 / $563.58 / $658.50	Professional	TC	$489.42	$563.58	$658.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $180.88 / $463.07	Professional		$32.34	$180.88	$463.07
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 $696.21 / $865.84 / $994.63	Professional		$696.21	$865.84	$994.63
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $193.31 / $227.42 / $273.45	Professional	26	$193.31	$227.42	$273.45
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $513.35 / $638.41 / $721.18	Professional	TC	$513.35	$638.41	$721.18
United Facility/Professional Professional Modifier Low / Median / High Price $383.15 / $474.62 / $925.79	Professional		$383.15	$474.62	$925.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.53 / $126.95 / $241.80	Professional	26	$99.53	$126.95	$241.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $280.38 / $358.65 / $679.46	Professional	TC	$280.38	$358.65	$679.46