Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $275.14 / $275.14 / $275.14	Facility	26	$275.14	$275.14	$275.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $452.18 / $522.50 / $734.02	Professional		$452.18	$522.50	$734.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.46 / $145.65 / $311.07	Professional	26	$121.46	$145.65	$311.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $285.82 / $343.92 / $502.80	Professional	TC	$285.82	$343.92	$502.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.58 / $337.06 / $693.99	Professional		$301.58	$337.06	$693.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.16 / $101.89 / $205.99	Professional	26	$91.16	$101.89	$205.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.42 / $235.17 / $484.39	Professional	TC	$210.42	$235.17	$484.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,315.19 / $1,315.19 / $1,675.84	Professional		$1,315.19	$1,315.19	$1,675.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $892.00 / $892.00 / $893.84	Professional	26	$892.00	$892.00	$893.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $782.00 / $782.00 / $782.00	Professional	TC	$782.00	$782.00	$782.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $555.60 / $639.79 / $842.24	Professional		$555.60	$639.79	$842.24
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.99 / $184.54 / $210.90	Professional	26	$173.99	$184.54	$210.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $381.61 / $404.74 / $462.56	Professional	TC	$381.61	$404.74	$462.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $196.38 / $542.99	Professional		$32.34	$196.38	$542.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $582.20 / $724.04 / $842.24	Professional		$582.20	$724.04	$842.24
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $188.07 / $221.26 / $266.38	Professional	26	$188.07	$221.26	$266.38
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $427.37 / $502.79 / $575.86	Professional	TC	$427.37	$502.79	$575.86
United Facility/Professional Professional Modifier Low / Median / High Price $343.26 / $626.70 / $1,321.32	Professional		$343.26	$626.70	$1,321.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.29 / $117.65 / $188.24	Professional	26	$70.29	$117.65	$188.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.26 / $539.23 / $1,010.22	Professional	TC	$243.26	$539.23	$1,010.22