Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $162.18 / $162.18	Facility	26	$141.25	$162.18	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $239.88 / $436.52	Professional		$151.36	$239.88	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $169.82	Professional	26	$56.23	$81.28	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $162.18 / $281.84	Professional	TC	$87.10	$162.18	$281.84
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 Professional Modifier Low / Median / High Price $239.88 / $281.84 / $389.05	Professional		$239.88	$281.84	$389.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $114.82 / $158.49	Professional	26	$97.72	$114.82	$158.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $165.96 / $229.09	Professional	TC	$141.25	$165.96	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $204.17 / $416.87	Professional		$125.89	$204.17	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $70.79 / $125.89	Professional	26	$50.12	$70.79	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $123.03 / $263.03	Professional	TC	$75.86	$123.03	$263.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $758.58	Professional		$676.08	$676.08	$758.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $478.63 / $478.63	Professional	26	$251.19	$478.63	$478.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $194.98 / $501.19	Professional	TC	$194.98	$194.98	$501.19
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $162.18 / $162.18	Facility	26	$141.25	$162.18	$162.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $295.12 / $446.68	Professional		$190.55	$295.12	$446.68
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $117.49 / $154.88	Professional	26	$63.10	$117.49	$154.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $177.83 / $316.23	Professional	TC	$120.23	$177.83	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $100.00	Professional		$32.36	$33.11	$100.00
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 Professional Modifier Low / Median / High Price $234.42 / $323.59 / $407.38	Professional		$234.42	$323.59	$407.38
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $120.23 / $154.88	Professional	26	$100.00	$120.23	$154.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $194.98 / $295.12	Professional	TC	$131.83	$194.98	$295.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $144.54 / $457.09	Professional		$141.25	$144.54	$457.09
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $131.83	Professional	26	$56.23	$56.23	$131.83
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $93.33 / $275.42	Professional	TC	$83.18	$93.33	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $457.09	Professional		$141.25	$208.93	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $66.07 / $131.83	Professional	26	$53.70	$66.07	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $154.88 / $323.59	Professional	TC	$87.10	$154.88	$323.59