Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $388.76 / $524.35 / $614.75	Professional		$388.76	$524.35	$614.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.71 / $66.45 / $103.40	Professional	26	$55.71	$66.45	$103.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $194.38 / $258.08 / $307.38	Professional	52	$194.38	$258.08	$307.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.36 / $452.26 / $517.55	Professional	TC	$335.36	$452.26	$517.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $540.08 / $648.09 / $799.29	Professional		$540.08	$648.09	$799.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.82 / $103.84 / $120.02	Professional	26	$87.82	$103.84	$120.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $452.26 / $542.71 / $659.00	Professional	TC	$452.26	$542.71	$659.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $662.87 / $703.05 / $803.48	Professional		$662.87	$703.05	$803.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.33 / $100.73 / $120.98	Professional	26	$92.33	$100.73	$120.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $570.54 / $622.40 / $691.56	Professional	TC	$570.54	$622.40	$691.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $105.38 / $640.99	Professional		$32.34	$105.38	$640.99
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $946.29 / $946.29 / $946.29	Facility	26	$946.29	$946.29	$946.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $444.34 / $611.91 / $660.13	Professional		$444.34	$611.91	$660.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $62.86 / $86.57 / $105.73	Professional	26	$62.86	$86.57	$105.73
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $381.48 / $525.36 / $554.40	Professional	TC	$381.48	$525.36	$554.40
United Facility/Professional Professional Modifier Low / Median / High Price $436.62 / $658.80 / $849.12	Professional		$436.62	$658.80	$849.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.31 / $91.00 / $125.18	Professional	26	$66.31	$91.00	$125.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $370.12 / $574.65 / $743.56	Professional	TC	$370.12	$574.65	$743.56