Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.60 / $134.60 / $134.60	Facility	26	$134.60	$134.60	$134.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.19 / $277.49 / $429.23	Professional		$216.19	$277.49	$429.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.21 / $58.94 / $111.02	Professional	26	$49.21	$58.94	$111.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $166.97 / $218.55 / $318.20	Professional	TC	$166.97	$218.55	$318.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.33 / $198.19 / $406.70	Professional		$177.33	$198.19	$406.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $48.78 / $99.82	Professional	26	$43.65	$48.78	$99.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.68 / $149.41 / $306.50	Professional	TC	$133.68	$149.41	$306.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,011.44 / $1,011.44 / $1,122.80	Professional		$1,011.44	$1,011.44	$1,122.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $383.90 / $383.90 / $383.90	Professional	26	$383.90	$383.90	$383.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $627.54 / $627.54 / $627.54	Professional	TC	$627.54	$627.54	$627.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $323.95 / $373.05 / $493.71	Professional		$323.95	$373.05	$493.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.73 / $87.75 / $100.28	Professional	26	$82.73	$87.75	$100.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $241.25 / $255.87 / $292.42	Professional	TC	$241.25	$255.87	$292.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $93.74 / $315.95	Professional		$32.34	$93.74	$315.95
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 $361.00 / $424.70 / $493.70	Professional		$361.00	$424.70	$493.70
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $90.25 / $106.18 / $127.73	Professional	26	$90.25	$106.18	$127.73
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $270.74 / $318.52 / $365.97	Professional	TC	$270.74	$318.52	$365.97
United Facility/Professional Professional Modifier Low / Median / High Price $192.69 / $248.52 / $444.73	Professional		$192.69	$248.52	$444.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.72 / $60.04 / $107.44	Professional	26	$45.72	$60.04	$107.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.97 / $188.48 / $337.29	Professional	TC	$146.97	$188.48	$337.29