Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $85.11 / $354.81	Facility		$54.95	$85.11	$354.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $19.50 / $22.39	Facility	26	$12.59	$19.50	$22.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $338.84 / $346.74	Facility	TC	$42.66	$338.84	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $40.74 / $97.72	Professional		$28.84	$40.74	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.80 / $40.74	Professional	26	$7.94	$13.80	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.84 / $58.88	Professional	TC	$20.89	$28.84	$58.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $194.98 / $354.81	Facility		$100.00	$194.98	$354.81
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $42.66 / $213.80	Facility	TC	$42.66	$42.66	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $66.07 / $91.20	Professional		$54.95	$66.07	$91.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.60 / $22.91	Professional	26	$13.80	$16.60	$22.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $48.98 / $67.61	Professional	TC	$41.69	$48.98	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $371.54 / $602.56	Facility		$147.91	$371.54	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $51.29 / $72.44	Professional		$35.48	$51.29	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.79 / $23.99	Professional	26	$10.96	$14.79	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $37.15 / $48.98	Professional	TC	$22.91	$37.15	$48.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $107.15	Professional		$87.10	$107.15	$107.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	26	$79.43	$79.43	$79.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.31 / $26.30 / $26.30	Professional	TC	$6.31	$26.30	$26.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $54.95 / $102.33	Facility		$32.36	$54.95	$102.33
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $19.50 / $22.39	Facility	26	$12.59	$19.50	$22.39
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $63.10 / $346.74	Facility	TC	$42.66	$63.10	$346.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $67.61 / $81.28	Professional		$37.15	$67.61	$81.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $17.38 / $24.55	Professional	26	$9.33	$17.38	$24.55
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $51.29 / $60.26	Professional	TC	$25.70	$51.29	$60.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $27.54 / $33.11	Professional		$6.92	$27.54	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $263.03 / $380.19	Facility		$213.80	$263.03	$380.19
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	TC	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $70.79 / $85.11	Professional		$57.54	$70.79	$85.11
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $17.78 / $21.88	Professional	26	$14.45	$17.78	$21.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $53.70 / $64.57	Professional	TC	$38.90	$53.70	$64.57
Select Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.88 / $85.11	Professional		$33.11	$33.88	$85.11
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.32 / $19.50	Professional	26	$8.32	$8.32	$19.50
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.20 / $57.54	Professional	TC	$24.55	$30.20	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.02 / $72.44	Professional		$36.31	$38.02	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.02 / $22.39	Professional	26	$10.47	$12.02	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $26.30 / $51.29	Professional	TC	$24.55	$26.30	$51.29