Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	26	$40.74	$40.74	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $93.33 / $190.55	Professional		$61.66	$93.33	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $30.90	Professional	26	$12.02	$14.13	$30.90
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 $158.49 / $186.21 / $257.04	Professional		$158.49	$186.21	$257.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.18 / $39.81	Professional	26	$23.99	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $141.25 / $177.83	Professional		$74.13	$141.25	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.88 / $30.20	Professional	26	$15.85	$21.88	$30.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $194.98	Professional		$173.78	$173.78	$194.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $46.77 / $46.77	Professional	26	$38.90	$46.77	$46.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $190.55 / $234.42	Professional		$100.00	$190.55	$234.42
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $29.51 / $33.88	Professional	26	$15.14	$29.51	$33.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $33.11 / $66.07	Professional		$12.02	$33.11	$66.07
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 $141.25 / $194.98 / $245.47	Professional		$141.25	$194.98	$245.47
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $29.51 / $37.15	Professional	26	$24.55	$29.51	$37.15
Select Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $95.50 / $245.47	Professional		$93.33	$95.50	$245.47
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $33.11	Professional	26	$14.79	$14.79	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $89.13 / $169.82	Professional		$79.43	$89.13	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.85 / $30.20	Professional	26	$15.14	$15.85	$30.20