Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $287.43 / $659.12 / $834.90	Facility		$287.43	$659.12	$834.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.72 / $62.29 / $70.94	Facility	26	$61.72	$62.29	$70.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.96 / $212.66 / $351.10	Professional		$166.96	$212.66	$351.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $38.14 / $62.29	Professional	26	$30.82	$38.14	$62.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.22 / $172.36 / $244.90	Professional	TC	$130.22	$172.36	$244.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $314.62 / $776.70 / $1,344.59	Facility		$314.62	$776.70	$1,344.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.87 / $276.02 / $391.85	Professional		$204.87	$276.02	$391.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.88 / $56.43 / $72.81	Professional	26	$41.88	$56.43	$72.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.19 / $228.35 / $336.61	Professional	TC	$161.19	$228.35	$336.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $497.85 / $497.85 / $632.29	Professional		$497.85	$497.85	$632.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $90.41 / $90.41 / $120.29	Professional	26	$90.41	$90.41	$120.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $377.56 / $377.56 / $541.88	Professional	TC	$377.56	$377.56	$541.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $169.62 / $256.02 / $389.80	Facility		$169.62	$256.02	$389.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $287.13 / $304.54 / $348.04	Professional		$287.13	$304.54	$348.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.85 / $64.54 / $73.76	Professional	26	$60.85	$64.54	$73.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.30 / $240.01 / $274.30	Professional	TC	$226.30	$240.01	$274.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $66.55 / $308.55	Professional		$32.34	$66.55	$308.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $445.42 / $635.64 / $778.79	Facility		$445.42	$635.64	$778.79
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 $251.79 / $269.14 / $288.52	Professional		$251.79	$269.14	$288.52
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $52.21 / $55.72 / $61.85	Professional	26	$52.21	$55.72	$61.85
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $199.58 / $213.43 / $226.67	Professional	TC	$199.58	$213.43	$226.67
United Facility/Professional Professional Modifier Low / Median / High Price $202.16 / $322.64 / $430.20	Professional		$202.16	$322.64	$430.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $49.64 / $71.54	Professional	26	$39.90	$49.64	$71.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.60 / $252.01 / $348.31	Professional	TC	$159.60	$252.01	$348.31