Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $147.91 / $389.05	Facility	26	$131.83	$147.91	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $1,380.38	Professional		$371.54	$524.81	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $165.96 / $436.52	Professional	26	$102.33	$165.96	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $346.74 / $870.96	Professional	TC	$251.19	$346.74	$870.96
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $630.96 / $870.96	Professional		$575.44	$630.96	$870.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $190.55 / $269.15	Professional	26	$162.18	$190.55	$269.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $436.52 / $602.56	Professional	TC	$407.38	$436.52	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $489.78 / $1,000.00	Professional		$295.12	$489.78	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $120.23 / $199.53	Professional	26	$85.11	$120.23	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $354.81 / $831.76	Professional	TC	$208.93	$354.81	$831.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $2,398.83 / $2,398.83	Professional		$1,230.27	$2,398.83	$2,398.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $724.44 / $724.44 / $724.44	Professional	26	$724.44	$724.44	$724.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $1,659.59 / $1,659.59	Professional	TC	$501.19	$1,659.59	$1,659.59
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $380.19 / $407.38	Facility	26	$131.83	$380.19	$407.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $645.65 / $1,348.96	Professional		$478.63	$645.65	$1,348.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $194.98 / $275.42	Professional	26	$128.82	$194.98	$275.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $467.74 / $794.33	Professional	TC	$338.84	$467.74	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $1,023.29	Professional		$524.81	$707.95	$1,023.29
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $204.17 / $257.04	Professional	26	$165.96	$204.17	$257.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $524.81 / $831.76	Professional	TC	$354.81	$524.81	$831.76
Select Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $323.59 / $1,230.27	Professional		$316.23	$323.59	$1,230.27
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $234.42	Professional	26	$95.50	$95.50	$234.42
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $245.47 / $912.01	Professional	TC	$218.78	$245.47	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $562.34 / $1,202.26	Professional		$338.84	$562.34	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $109.65 / $208.93	Professional	26	$89.13	$109.65	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $467.74 / $1,000.00	Professional	TC	$245.47	$467.74	$1,000.00