Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $263.03 / $263.03	Facility	26	$181.97	$263.03	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $1,348.96	Professional		$281.84	$478.63	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $223.87	Professional	26	$70.79	$125.89	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $338.84 / $707.95	Professional	TC	$208.93	$338.84	$707.95
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $489.78 / $676.08	Professional		$436.52	$489.78	$676.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $131.83 / $181.97	Professional	26	$112.20	$131.83	$181.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $354.81 / $489.78	Professional	TC	$316.23	$354.81	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $389.05 / $676.08	Professional		$234.42	$389.05	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $83.18 / $169.82	Professional	26	$58.88	$83.18	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $295.12 / $537.03	Professional	TC	$173.78	$295.12	$537.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,584.89	Professional		$1,445.44	$1,445.44	$1,584.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $524.81 / $524.81	Professional	26	$281.84	$524.81	$524.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $912.01 / $912.01 / $1,318.26	Professional	TC	$912.01	$912.01	$1,318.26
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $512.86 / $891.25	Professional		$426.58	$512.86	$891.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $134.90 / $186.21	Professional	26	$104.71	$134.90	$186.21
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $380.19 / $707.95	Professional	TC	$302.00	$380.19	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $173.78	Professional		$32.36	$33.11	$173.78
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $562.34 / $660.69	Professional		$416.87	$562.34	$660.69
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $138.04 / $177.83	Professional	26	$114.82	$138.04	$177.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $426.58 / $537.03	Professional	TC	$295.12	$426.58	$537.03
Select Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $245.47 / $588.84	Professional		$239.88	$245.47	$588.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $162.18	Professional	26	$64.57	$64.57	$162.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $199.53 / $630.96	Professional	TC	$177.83	$199.53	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $380.19 / $776.25	Professional		$269.15	$380.19	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $75.86 / $141.25	Professional	26	$60.26	$75.86	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $295.12 / $616.60	Professional	TC	$204.17	$295.12	$616.60