Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $213.80 / $1,737.80	Facility	26	$107.15	$213.80	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $741.31	Professional		$257.04	$389.05	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $100.00 / $229.09	Professional	26	$74.13	$100.00	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $549.54	Professional	TC	$169.82	$281.84	$549.54
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 $416.87 / $489.78 / $676.08	Professional		$416.87	$489.78	$676.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $154.88 / $218.78	Professional	26	$131.83	$154.88	$218.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $457.09	Professional	TC	$281.84	$331.13	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $363.08 / $776.25	Professional		$229.09	$363.08	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $97.72 / $165.96	Professional	26	$69.18	$97.72	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $245.47 / $660.69	Professional	TC	$162.18	$245.47	$660.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,258.93 / $1,258.93	Professional		$851.14	$1,258.93	$1,258.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	26	$338.84	$338.84	$338.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $912.01 / $912.01	Professional	TC	$524.81	$912.01	$912.01
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $218.78 / $275.42	Facility	26	$120.23	$218.78	$275.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $524.81 / $758.58	Professional		$309.03	$524.81	$758.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $151.36 / $223.87	Professional	26	$77.62	$151.36	$223.87
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $371.54 / $549.54	Professional	TC	$213.80	$371.54	$549.54
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 $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $933.25	Professional		$398.11	$575.44	$933.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $165.96 / $208.93	Professional	26	$134.90	$165.96	$208.93
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $794.33	Professional	TC	$281.84	$416.87	$794.33
Select Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $245.47 / $831.76	Professional		$239.88	$245.47	$831.76
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $181.97	Professional	26	$77.62	$77.62	$181.97
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $204.17 / $457.09	Professional	TC	$165.96	$204.17	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $489.78 / $1,071.52	Professional		$257.04	$489.78	$1,071.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $89.13 / $177.83	Professional	26	$72.44	$89.13	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $363.08 / $870.96	Professional	TC	$177.83	$363.08	$870.96