Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $10.96 / $22.39	Facility	26	$10.96	$10.96	$22.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $74.13	Professional		$25.70	$34.67	$74.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $23.99	Professional	26	$6.03	$8.91	$23.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.12 / $53.70	Professional	TC	$18.20	$25.12	$53.70
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $81.28	Professional		$50.12	$58.88	$81.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.85 / $21.88	Professional	26	$13.49	$15.85	$21.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $42.66 / $60.26	Professional	TC	$36.31	$42.66	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $45.71 / $60.26	Professional		$29.51	$45.71	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $17.78	Professional	26	$8.71	$12.88	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $32.36 / $42.66	Professional	TC	$20.42	$32.36	$42.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $93.33	Professional		$83.18	$83.18	$93.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $36.31 / $36.31	Professional	26	$30.20	$36.31	$36.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $63.10	Professional	TC	$47.86	$47.86	$63.10
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $10.96 / $10.96	Facility	26	$10.96	$10.96	$10.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $61.66 / $77.62	Professional		$30.90	$61.66	$77.62
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.85 / $20.42	Professional	26	$7.94	$15.85	$20.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $45.71 / $53.70	Professional	TC	$22.91	$45.71	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $24.55 / $33.11	Professional		$6.61	$24.55	$33.11
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $77.62	Professional		$50.12	$64.57	$77.62
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.60 / $20.89	Professional	26	$13.49	$16.60	$20.89
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $46.77 / $56.23	Professional	TC	$36.31	$46.77	$56.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.90 / $77.62	Professional		$30.20	$30.90	$77.62
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $18.20	Professional	26	$7.94	$7.94	$18.20
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $26.30 / $50.12	Professional	TC	$21.88	$26.30	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $32.36 / $63.10	Professional		$30.20	$32.36	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.12 / $17.78	Professional	26	$8.51	$9.12	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $23.44 / $44.67	Professional	TC	$22.39	$23.44	$44.67