Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.97 / $480.48 / $650.89	Facility		$205.97	$480.48	$650.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.61 / $37.90 / $43.74	Facility	26	$36.61	$37.90	$43.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.58 / $138.90 / $239.31	Professional		$103.58	$138.90	$239.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $25.86 / $75.84	Professional	26	$18.44	$25.86	$75.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $116.35 / $189.87	Professional	TC	$95.53	$116.35	$189.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.86 / $367.78 / $603.27	Facility		$148.86	$367.78	$603.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.43 / $230.11 / $277.68	Professional		$162.43	$230.11	$277.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.19 / $35.44 / $45.41	Professional	26	$24.19	$35.44	$45.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.85 / $192.46 / $237.47	Professional	TC	$135.85	$192.46	$237.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $426.31 / $426.31 / $533.15	Professional		$426.31	$426.31	$533.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.90 / $65.90 / $90.22	Professional	26	$65.90	$65.90	$90.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $336.09 / $336.09 / $467.25	Professional	TC	$336.09	$336.09	$467.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $128.43 / $181.74 / $308.58	Facility		$128.43	$181.74	$308.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $226.83 / $240.57 / $274.94	Professional		$226.83	$240.57	$274.94
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.76 / $37.92 / $43.34	Professional	26	$35.76	$37.92	$43.34
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $191.07 / $202.65 / $231.60	Professional	TC	$191.07	$202.65	$231.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $40.15 / $227.72	Professional		$32.34	$40.15	$227.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $208.18 / $294.35 / $356.44	Facility		$208.18	$294.35	$356.44
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $211.40 / $211.40 / $211.40	Facility	26	$211.40	$211.40	$211.40
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $199.12 / $214.92 / $228.78	Professional		$199.12	$214.92	$228.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $31.42 / $33.83 / $37.67	Professional	26	$31.42	$33.83	$37.67
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $167.71 / $181.09 / $191.11	Professional	TC	$167.71	$181.09	$191.11
United Facility/Professional Professional Modifier Low / Median / High Price $161.12 / $237.44 / $341.04	Professional		$161.12	$237.44	$341.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.94 / $30.53 / $46.23	Professional	26	$23.94	$30.53	$46.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $207.99 / $309.12	Professional	TC	$134.90	$207.99	$309.12