Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.31 / $331.31 / $331.31	Facility		$331.31	$331.31	$331.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $161.54 / $161.54 / $161.54	Facility	26	$161.54	$161.54	$161.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $169.77 / $169.77 / $169.77	Facility	TC	$169.77	$169.77	$169.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.31 / $331.31 / $683.91	Professional		$308.31	$331.31	$683.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $159.71 / $161.54 / $270.20	Professional	26	$159.71	$161.54	$270.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.61 / $169.77 / $502.33	Professional	TC	$148.61	$169.77	$502.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $308.31 / $507.81 / $610.01	Facility		$308.31	$507.81	$610.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $584.96 / $620.41 / $655.86	Professional		$584.96	$620.41	$655.86
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $275.39 / $292.08 / $308.77	Professional	26	$275.39	$292.08	$308.77
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.56 / $328.32 / $347.08	Professional	TC	$309.56	$328.32	$347.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $315.00 / $646.04	Professional		$30.00	$315.00	$646.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $534.08 / $541.78 / $627.64	Professional		$534.08	$541.78	$627.64
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $237.15 / $255.72 / $269.88	Professional	26	$237.15	$255.72	$269.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $286.06 / $286.06 / $357.76	Professional	TC	$286.06	$286.06	$357.76
United Facility/Professional Professional Modifier Low / Median / High Price $208.74 / $347.90 / $487.06	Professional		$208.74	$347.90	$487.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.26 / $111.30 / $185.50	Professional	26	$109.26	$111.30	$185.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.44 / $178.23 / $293.27	Professional	TC	$97.44	$178.23	$293.27