Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $191.50 / $191.50 / $191.50	Facility	26	$191.50	$191.50	$191.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.22 / $467.23 / $522.50	Professional		$263.22	$467.23	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.65 / $140.00 / $160.93	Professional	26	$84.65	$140.00	$160.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.41 / $306.30 / $348.53	Professional	TC	$173.41	$306.30	$348.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.98 / $213.45 / $437.87	Professional		$190.98	$213.45	$437.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.28 / $70.73 / $144.04	Professional	26	$63.28	$70.73	$144.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.70 / $142.72 / $293.79	Professional	TC	$127.70	$142.72	$293.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,089.77 / $1,089.77 / $1,209.74	Professional		$1,089.77	$1,089.77	$1,209.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $550.26 / $550.26 / $550.26	Professional	26	$550.26	$550.26	$550.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $539.51 / $539.51 / $539.51	Professional	TC	$539.51	$539.51	$539.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $354.92 / $408.69 / $492.13	Professional		$354.92	$408.69	$492.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.09 / $127.37 / $145.56	Professional	26	$120.09	$127.37	$145.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $234.83 / $249.06 / $284.64	Professional	TC	$234.83	$249.06	$284.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $136.16 / $347.85	Professional		$32.34	$136.16	$347.85
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 $393.02 / $462.38 / $539.04	Professional		$393.02	$462.38	$539.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $130.41 / $153.44 / $185.38	Professional	26	$130.41	$153.44	$185.38
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $262.60 / $308.94 / $353.67	Professional	TC	$262.60	$308.94	$353.67
United Facility/Professional Professional Modifier Low / Median / High Price $217.18 / $481.43 / $1,074.06	Professional		$217.18	$481.43	$1,074.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.42 / $81.92 / $154.35	Professional	26	$67.42	$81.92	$154.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.55 / $387.72 / $962.57	Professional	TC	$147.55	$387.72	$962.57