Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.23 / $103.23 / $103.23	Facility	26	$103.23	$103.23	$103.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $300.60 / $1,031.00	Professional		$215.53	$300.60	$1,031.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.49 / $86.75 / $279.24	Professional	26	$56.49	$86.75	$279.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $142.71 / $171.78 / $268.64	Professional	TC	$142.71	$171.78	$268.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.44 / $341.30 / $437.30	Professional		$244.44	$341.30	$437.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.98 / $96.03 / $123.04	Professional	26	$67.98	$96.03	$123.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.52 / $245.27 / $314.26	Professional	TC	$164.52	$245.27	$314.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $792.77 / $792.77 / $1,394.40	Professional		$792.77	$792.77	$1,394.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $267.74 / $267.74 / $267.74	Professional	26	$267.74	$267.74	$267.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $525.03 / $525.03 / $1,126.66	Professional	TC	$525.03	$525.03	$1,126.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $328.60 / $365.10 / $417.26	Professional		$328.60	$365.10	$417.26
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.06 / $101.89 / $116.44	Professional	26	$96.06	$101.89	$116.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $248.18 / $263.22 / $300.82	Professional	TC	$248.18	$263.22	$300.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $109.51 / $374.99	Professional		$32.34	$109.51	$374.99
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $936.81 / $936.81 / $936.81	Facility	26	$936.81	$936.81	$936.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $324.98 / $327.36 / $370.45	Professional		$324.98	$327.36	$370.45
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $88.06 / $89.55 / $108.56	Professional	26	$88.06	$89.55	$108.56
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $236.93 / $237.81 / $272.16	Professional	TC	$236.93	$237.81	$272.16
United Facility/Professional Professional Modifier Low / Median / High Price $237.47 / $317.72 / $437.28	Professional		$237.47	$317.72	$437.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.04 / $97.74 / $119.07	Professional	26	$68.04	$97.74	$119.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.15 / $219.44 / $313.02	Professional	TC	$172.15	$219.44	$313.02