Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $186.21 / $186.21	Facility	26	$186.21	$186.21	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $776.25	Professional		$251.19	$426.58	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $223.87	Professional	26	$70.79	$112.20	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $549.54	Professional	TC	$177.83	$302.00	$549.54
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 $436.52 / $457.09 / $630.96	Professional		$436.52	$457.09	$630.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $134.90 / $186.21	Professional	26	$114.82	$134.90	$186.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $323.59 / $446.68	Professional	TC	$309.03	$323.59	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $426.58 / $741.31	Professional		$208.93	$426.58	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $74.13 / $169.82	Professional	26	$58.88	$74.13	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $288.40 / $660.69	Professional	TC	$151.36	$288.40	$660.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,584.89	Professional		$1,445.44	$1,445.44	$1,584.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $630.96 / $630.96	Professional	26	$199.53	$630.96	$630.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $794.33 / $1,412.54	Professional	TC	$794.33	$794.33	$1,412.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $489.78 / $794.33	Professional		$407.38	$489.78	$794.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $131.83 / $190.55	Professional	26	$100.00	$131.83	$190.55
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $346.74 / $630.96	Professional	TC	$288.40	$346.74	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $162.18	Professional		$32.36	$33.11	$162.18
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 $354.81 / $524.81 / $891.25	Professional		$354.81	$524.81	$891.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $141.25 / $181.97	Professional	26	$97.72	$141.25	$181.97
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $380.19 / $776.25	Professional	TC	$257.04	$380.19	$776.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $234.42 / $1,023.29	Professional		$229.09	$234.42	$1,023.29
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $158.49	Professional	26	$66.07	$66.07	$158.49
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $181.97 / $912.01	Professional	TC	$162.18	$181.97	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $467.74 / $1,000.00	Professional		$239.88	$467.74	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $131.83	Professional	26	$50.12	$77.62	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $346.74 / $870.96	Professional	TC	$173.78	$346.74	$870.96