Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.08 / $218.12 / $461.48	Facility		$217.08	$218.12	$461.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.83 / $37.83 / $44.31	Facility	26	$37.83	$37.83	$44.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.16 / $129.78 / $196.78	Professional		$109.16	$129.78	$196.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $22.95 / $34.03	Professional	26	$20.07	$22.95	$34.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $106.95 / $161.71	Professional	TC	$86.20	$106.95	$161.71
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 $132.02 / $187.45 / $297.83	Professional		$132.02	$187.45	$297.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.02 / $34.81 / $44.91	Professional	26	$25.02	$34.81	$44.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.37 / $149.28 / $233.16	Professional	TC	$105.37	$149.28	$233.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $366.45 / $366.45 / $410.95	Professional		$366.45	$366.45	$410.95
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.50 / $56.50 / $88.55	Professional	26	$56.50	$56.50	$88.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $277.89 / $277.89 / $354.45	Professional	TC	$277.89	$277.89	$354.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $109.61 / $169.60 / $269.58	Facility		$109.61	$169.60	$269.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $186.27 / $197.56 / $225.78	Professional		$186.27	$197.56	$225.78
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.83 / $39.06 / $44.64	Professional	26	$36.83	$39.06	$44.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $149.44 / $158.50 / $181.14	Professional	TC	$149.44	$158.50	$181.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $41.01 / $200.81	Professional		$32.34	$41.01	$200.81
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 $163.09 / $176.12 / $187.90	Professional		$163.09	$176.12	$187.90
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $31.88 / $34.83 / $38.20	Professional	26	$31.88	$34.83	$38.20
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $131.21 / $141.29 / $149.69	Professional	TC	$131.21	$141.29	$149.69
United Facility/Professional Professional Modifier Low / Median / High Price $129.96 / $201.79 / $290.00	Professional		$129.96	$201.79	$290.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $33.17 / $46.90	Professional	26	$25.26	$33.17	$46.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.08 / $182.25 / $244.15	Professional	TC	$103.08	$182.25	$244.15