Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.80 / $551.63 / $773.12	Facility		$284.80	$551.63	$773.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.41 / $97.04 / $97.85	Facility	26	$55.41	$97.04	$97.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.70 / $150.22 / $357.30	Professional		$115.70	$150.22	$357.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $44.40 / $140.26	Professional	26	$34.67	$44.40	$140.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.65 / $100.06 / $176.87	Professional	TC	$71.65	$100.06	$176.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.86 / $367.78 / $603.27	Facility		$148.86	$367.78	$603.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.87 / $181.07 / $233.38	Professional		$116.87	$181.07	$233.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $59.42 / $76.40	Professional	26	$40.56	$59.42	$76.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.97 / $124.09 / $152.11	Professional	TC	$76.97	$124.09	$152.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $348.40 / $348.40 / $373.20	Professional		$348.40	$348.40	$373.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $171.22 / $171.22 / $190.04	Professional	26	$171.22	$171.22	$190.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.18 / $177.18 / $183.16	Professional	TC	$177.18	$177.18	$183.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.48 / $239.33 / $342.24	Facility		$108.48	$239.33	$342.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $184.67 / $207.05 / $252.01	Professional		$184.67	$207.05	$252.01
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.85 / $64.54 / $73.76	Professional	26	$60.85	$64.54	$73.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.82 / $131.32 / $150.08	Professional	TC	$123.82	$131.32	$150.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $68.84 / $201.18	Professional		$32.34	$68.84	$201.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $211.40 / $288.06 / $458.49	Facility		$211.40	$288.06	$458.49
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $203.21 / $239.07 / $275.38	Professional		$203.21	$239.07	$275.38
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $65.80 / $77.41 / $93.55	Professional	26	$65.80	$77.41	$93.55
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $137.41 / $161.66 / $181.83	Professional	TC	$137.41	$161.66	$181.83
United Facility/Professional Professional Modifier Low / Median / High Price $125.23 / $143.63 / $258.27	Professional		$125.23	$143.63	$258.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.47 / $44.08 / $78.87	Professional	26	$39.47	$44.08	$78.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.37 / $104.16 / $187.28	Professional	TC	$83.37	$104.16	$187.28