Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.60 / $227.30 / $436.57	Professional		$163.60	$227.30	$436.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.10 / $49.28 / $70.01	Professional	26	$42.10	$49.28	$70.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.19 / $195.82 / $366.55	Professional	TC	$145.19	$195.82	$366.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.25 / $406.92 / $665.42	Professional		$302.25	$406.92	$665.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.88 / $70.44 / $91.05	Professional	26	$49.88	$70.44	$91.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $248.95 / $341.50 / $542.69	Professional	TC	$248.95	$341.50	$542.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $619.03 / $619.03 / $746.08	Professional		$619.03	$619.03	$746.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $167.46 / $167.46 / $170.93	Professional	26	$167.46	$167.46	$170.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $448.10 / $448.10 / $578.62	Professional	TC	$448.10	$448.10	$578.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $409.89 / $434.74 / $496.84	Professional		$409.89	$434.74	$496.84
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.51 / $75.84 / $86.68	Professional	26	$71.51	$75.84	$86.68
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.38 / $358.89 / $410.16	Professional	TC	$338.38	$358.89	$410.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $80.84 / $443.10	Professional		$32.34	$80.84	$443.10
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 $373.76 / $409.44 / $433.12	Professional		$373.76	$409.44	$433.12
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $62.37 / $67.66 / $75.84	Professional	26	$62.37	$67.66	$75.84
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $311.39 / $341.78 / $357.27	Professional	TC	$311.39	$341.78	$357.27
United Facility/Professional Professional Modifier Low / Median / High Price $277.89 / $439.74 / $586.30	Professional		$277.89	$439.74	$586.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.96 / $68.50 / $87.75	Professional	26	$48.96	$68.50	$87.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $241.30 / $382.62 / $510.15	Professional	TC	$241.30	$382.62	$510.15