Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $182.88 / $219.66 / $244.58	Facility	26	$182.88	$219.66	$244.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $680.08 / $786.19 / $1,309.27	Professional		$680.08	$786.19	$1,309.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.21 / $137.44 / $346.89	Professional	26	$118.21	$137.44	$346.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $304.37 / $381.18 / $494.79	Professional	52	$304.37	$381.18	$494.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $538.07 / $662.27 / $960.19	Professional	TC	$538.07	$662.27	$960.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $837.94 / $984.30 / $1,145.18	Professional		$837.94	$984.30	$1,145.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $173.66 / $205.16 / $237.34	Professional	26	$173.66	$205.16	$237.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $664.28 / $797.13 / $907.84	Professional	TC	$664.28	$797.13	$907.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,003.93 / $1,064.77 / $1,216.88	Professional		$1,003.93	$1,064.77	$1,216.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $185.20 / $202.03 / $239.20	Professional	26	$185.20	$202.03	$239.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $818.73 / $893.16 / $992.40	Professional	TC	$818.73	$893.16	$992.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $210.99 / $973.75	Professional		$32.34	$210.99	$973.75
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,784.45 / $1,784.45 / $1,784.45	Facility	26	$1,784.45	$1,784.45	$1,784.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $676.26 / $931.32 / $1,040.08	Professional		$676.26	$931.32	$1,040.08
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $125.36 / $172.63 / $211.04	Professional	26	$125.36	$172.63	$211.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $550.91 / $758.69 / $829.05	Professional	TC	$550.91	$758.69	$829.05
United Facility/Professional Professional Modifier Low / Median / High Price $653.97 / $901.31 / $1,170.28	Professional		$653.97	$901.31	$1,170.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.52 / $174.92 / $262.89	Professional	26	$128.52	$174.92	$262.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $522.87 / $715.52 / $954.01	Professional	TC	$522.87	$715.52	$954.01