Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $213.80 / $218.78	Facility	26	$81.28	$213.80	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $478.63 / $977.24	Professional		$229.09	$478.63	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $117.49 / $208.93	Professional	26	$57.54	$117.49	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $338.84 / $562.34	Professional	TC	$165.96	$338.84	$562.34
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $398.11 / $562.34	Professional		$380.19	$398.11	$562.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $107.15 / $147.91	Professional	26	$91.20	$107.15	$147.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $295.12 / $407.38	Professional	TC	$275.42	$295.12	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $380.19 / $707.95	Professional		$186.21	$380.19	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $66.07 / $158.49	Professional	26	$47.86	$66.07	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $275.42 / $630.96	Professional	TC	$138.04	$275.42	$630.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,348.96 / $1,348.96	Professional		$1,000.00	$1,348.96	$1,348.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $346.74 / $436.52 / $436.52	Professional	26	$346.74	$436.52	$436.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $912.01 / $912.01	Professional	TC	$660.69	$912.01	$912.01
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $213.80 / $218.78	Facility	26	$81.28	$213.80	$218.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $426.58 / $794.33	Professional		$354.81	$426.58	$794.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $165.96	Professional	26	$81.28	$109.65	$165.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $316.23 / $630.96	Professional	TC	$257.04	$316.23	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $831.76	Professional		$331.13	$467.74	$831.76
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $112.20 / $144.54	Professional	26	$93.33	$112.20	$144.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $346.74 / $724.44	Professional	TC	$234.42	$346.74	$724.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $204.17 / $851.14	Professional		$199.53	$204.17	$851.14
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $125.89	Professional	26	$52.48	$52.48	$125.89
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $165.96 / $630.96	Professional	TC	$147.91	$165.96	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $436.52 / $933.25	Professional		$213.80	$436.52	$933.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $61.66 / $120.23	Professional	26	$50.12	$61.66	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $316.23 / $812.83	Professional	TC	$158.49	$316.23	$812.83