Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $138.04 / $141.25	Facility	26	$77.62	$138.04	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $323.59 / $724.44	Professional		$181.97	$323.59	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $81.28 / $173.78	Professional	26	$53.70	$81.28	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $223.87 / $398.11	Professional	TC	$128.82	$223.87	$398.11
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $331.13 / $467.74	Professional		$316.23	$331.13	$467.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $100.00 / $141.25	Professional	26	$95.50	$100.00	$141.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $234.42 / $331.13	Professional	TC	$223.87	$234.42	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $323.59 / $512.86	Professional		$151.36	$323.59	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $75.86 / $128.82	Professional	26	$44.67	$75.86	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $223.87 / $389.05	Professional	TC	$107.15	$223.87	$389.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $977.24	Professional		$870.96	$870.96	$977.24
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $331.13 / $331.13	Professional	26	$239.88	$331.13	$331.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $537.03 / $724.44	Professional	TC	$537.03	$537.03	$724.44
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $141.25 / $141.25	Facility	26	$77.62	$141.25	$141.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $363.08 / $549.54	Professional		$234.42	$363.08	$549.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $102.33 / $144.54	Professional	26	$58.88	$102.33	$144.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $257.04 / $407.38	Professional	TC	$177.83	$257.04	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $120.23	Professional		$32.36	$33.11	$120.23
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $380.19 / $588.84	Professional		$302.00	$380.19	$588.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $109.65 / $134.90	Professional	26	$87.10	$109.65	$134.90
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $275.42 / $467.74	Professional	TC	$186.21	$275.42	$467.74
Select Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $169.82 / $676.08	Professional		$165.96	$169.82	$676.08
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $50.12 / $120.23	Professional	26	$50.12	$50.12	$120.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $131.83 / $457.09	Professional	TC	$117.49	$131.83	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $645.65	Professional		$194.98	$302.00	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $60.26 / $138.04	Professional	26	$48.98	$60.26	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $239.88 / $512.86	Professional	TC	$144.54	$239.88	$512.86