Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $109.65 / $398.11	Professional		$58.88	$109.65	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $58.88 / $120.23	Professional	26	$34.67	$58.88	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $40.74 / $173.78	Professional	TC	$25.70	$40.74	$173.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $245.47 / $467.74	Facility		$138.04	$245.47	$467.74
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $120.23 / $128.82	Professional		$97.72	$120.23	$128.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $74.13	Professional	26	$56.23	$70.79	$74.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $51.29 / $53.70	Professional	TC	$40.74	$51.29	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $245.47	Professional		$83.18	$104.71	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $60.26 / $102.33	Professional	26	$44.67	$60.26	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $46.77 / $147.91	Professional	TC	$34.67	$46.77	$147.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $154.88 / $380.19	Facility		$63.10	$154.88	$380.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $120.23 / $251.19	Professional		$61.66	$120.23	$251.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $70.79 / $93.33	Professional	26	$38.90	$70.79	$93.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $56.23 / $151.36	Professional	TC	$30.90	$56.23	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $354.81 / $501.19	Facility		$281.84	$354.81	$501.19
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $138.04	Professional		$79.43	$95.50	$138.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $77.62	Professional	26	$44.67	$54.95	$77.62
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $40.74 / $60.26	Professional	TC	$34.67	$40.74	$60.26
Select Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $72.44 / $363.08	Professional		$61.66	$72.44	$363.08
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $83.18	Professional	26	$34.67	$34.67	$83.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $26.92 / $61.66	Professional	TC	$26.92	$26.92	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $8,317.64 / $9,332.54	Facility		$1,819.70	$8,317.64	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $154.88 / $371.54	Professional		$72.44	$154.88	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $77.62 / $158.49	Professional	26	$41.69	$77.62	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $67.61 / $229.09	Professional	TC	$30.90	$67.61	$229.09