Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	26	$30.90	$30.90	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $128.82	Professional		$41.69	$54.95	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $27.54	Professional	26	$8.91	$12.02	$27.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $41.69 / $95.50	Professional	TC	$32.36	$41.69	$95.50
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 $81.28 / $95.50 / $134.90	Professional		$81.28	$95.50	$134.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $21.38 / $30.20	Professional	26	$18.20	$21.38	$30.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $74.13 / $104.71	Professional	TC	$63.10	$74.13	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $75.86 / $100.00	Professional		$46.77	$75.86	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $17.38 / $24.55	Professional	26	$12.30	$17.38	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $57.54 / $75.86	Professional	TC	$33.11	$57.54	$75.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $169.82	Professional		$154.88	$154.88	$169.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $61.66	Professional	26	$51.29	$61.66	$61.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $91.20 / $120.23	Professional	TC	$91.20	$91.20	$120.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $93.33 / $123.03	Professional		$53.70	$93.33	$123.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $21.38 / $25.70	Professional	26	$10.96	$21.38	$25.70
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $74.13 / $93.33	Professional	TC	$38.90	$74.13	$93.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $32.36 / $34.67	Professional		$9.12	$32.36	$34.67
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 $74.13 / $107.15 / $125.89	Professional		$74.13	$107.15	$125.89
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.91 / $28.84	Professional	26	$18.62	$22.91	$28.84
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $83.18 / $97.72	Professional	TC	$57.54	$83.18	$97.72
Select Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $50.12 / $125.89	Professional		$48.98	$50.12	$125.89
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $10.96 / $25.12	Professional	26	$10.96	$10.96	$25.12
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $45.71 / $87.10	Professional	TC	$38.90	$45.71	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $52.48 / $102.33	Professional		$48.98	$52.48	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.88 / $25.12	Professional	26	$12.30	$12.88	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $39.81 / $75.86	Professional	TC	$37.15	$39.81	$75.86