Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.87 / $60.87 / $77.51	Facility	26	$60.87	$60.87	$77.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.33 / $299.41 / $446.26	Professional		$228.33	$299.41	$446.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.67 / $40.90 / $56.38	Professional	26	$35.67	$40.90	$56.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.82 / $258.50 / $361.09	Professional	TC	$191.82	$258.50	$361.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $289.12 / $373.45 / $481.87	Professional		$289.12	$373.45	$481.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.72 / $57.34 / $73.67	Professional	26	$41.72	$57.34	$73.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $246.00 / $319.70 / $409.99	Professional	TC	$246.00	$319.70	$409.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $779.63 / $779.63 / $939.64	Professional		$779.63	$779.63	$939.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $133.66 / $133.66 / $133.66	Professional	26	$133.66	$133.66	$133.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $645.97 / $645.97 / $645.97	Professional	TC	$645.97	$645.97	$645.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $393.89 / $417.76 / $477.44	Professional		$393.89	$417.76	$477.44
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.31 / $63.96 / $73.09	Professional	26	$60.31	$63.96	$73.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $333.58 / $353.80 / $404.34	Professional	TC	$333.58	$353.80	$404.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $65.70 / $422.53	Professional		$32.34	$65.70	$422.53
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 $348.81 / $369.64 / $395.75	Professional		$348.81	$369.64	$395.75
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $51.74 / $55.22 / $61.31	Professional	26	$51.74	$55.22	$61.31
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $297.07 / $314.42 / $334.44	Professional	TC	$297.07	$314.42	$334.44
United Facility/Professional Professional Modifier Low / Median / High Price $271.75 / $376.50 / $504.50	Professional		$271.75	$376.50	$504.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $55.01 / $73.70	Professional	26	$39.70	$55.01	$73.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.05 / $321.51 / $417.94	Professional	TC	$232.05	$321.51	$417.94