Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $178.85 / $178.85 / $198.04	Facility	26	$178.85	$178.85	$198.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $91.23 / $91.23 / $91.23	Facility	53	$91.23	$91.23	$91.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.77 / $340.84 / $401.31	Professional		$252.77	$340.84	$401.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $119.71 / $520.00	Professional	26	$52.17	$119.71	$520.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.22 / $389.89 / $584.89	Professional		$275.22	$389.89	$584.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.26 / $166.73 / $208.41	Professional	26	$118.26	$166.73	$208.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $664.72 / $664.72 / $912.49	Professional		$664.72	$664.72	$912.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $418.32 / $418.32 / $537.94	Professional	26	$418.32	$418.32	$537.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $372.01 / $394.56 / $450.92	Professional		$372.01	$394.56	$450.92
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $166.52 / $176.61 / $201.84	Professional	26	$166.52	$176.61	$201.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $170.57 / $219.65	Professional		$32.34	$170.57	$219.65
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 $347.36 / $351.24 / $470.55	Professional		$347.36	$351.24	$470.55
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $152.76 / $154.72 / $186.44	Professional	26	$152.76	$154.72	$186.44
United Facility/Professional Professional Modifier Low / Median / High Price $264.47 / $417.15 / $565.47	Professional		$264.47	$417.15	$565.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.60 / $161.02 / $209.04	Professional	26	$112.60	$161.02	$209.04