Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.69 / $138.69 / $154.19	Facility	26	$138.69	$138.69	$154.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.81 / $299.55 / $1,064.00	Professional		$226.81	$299.55	$1,064.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.70 / $106.76 / $361.00	Professional	26	$86.70	$106.76	$361.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.38 / $176.93 / $257.39	Professional	TC	$151.38	$176.93	$257.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.22 / $355.00 / $486.16	Professional		$263.22	$355.00	$486.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.89 / $129.22 / $165.56	Professional	26	$90.89	$129.22	$165.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.09 / $235.34 / $284.11	Professional	TC	$157.09	$235.34	$284.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $679.67 / $679.67 / $823.43	Professional		$679.67	$679.67	$823.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $315.41 / $315.41 / $316.43	Professional	26	$315.41	$315.41	$316.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $364.26 / $364.26 / $507.00	Professional	TC	$364.26	$364.26	$507.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $367.19 / $389.45 / $445.08	Professional		$367.19	$389.45	$445.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $129.16 / $136.99 / $156.56	Professional	26	$129.16	$136.99	$156.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $238.05 / $252.47 / $288.54	Professional	TC	$238.05	$252.47	$288.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $147.34 / $401.66	Professional		$32.34	$147.34	$401.66
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 $339.58 / $346.26 / $415.36	Professional		$339.58	$346.26	$415.36
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $118.71 / $120.40 / $161.07	Professional	26	$118.71	$120.40	$161.07
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $220.87 / $225.87 / $254.29	Professional	TC	$220.87	$225.87	$254.29
United Facility/Professional Professional Modifier Low / Median / High Price $251.93 / $352.00 / $450.83	Professional		$251.93	$352.00	$450.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.34 / $131.07 / $164.57	Professional	26	$87.34	$131.07	$164.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.97 / $227.32 / $287.27	Professional	TC	$159.97	$227.32	$287.27