Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $229.09 / $354.81	Facility		$39.81	$229.09	$354.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $21.38 / $26.92	Facility	26	$11.48	$21.38	$26.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $281.84 / $660.69	Facility	TC	$39.81	$281.84	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $28.18 / $72.44	Professional		$18.62	$28.18	$72.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.30 / $38.90	Professional	26	$7.94	$12.30	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $19.05 / $38.02	Professional	TC	$10.23	$19.05	$38.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $181.97 / $269.15	Facility		$63.10	$181.97	$269.15
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $26.92 / $158.49	Facility	TC	$26.92	$26.92	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $47.86 / $66.07	Professional		$39.81	$47.86	$66.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.60 / $22.91	Professional	26	$13.80	$16.60	$22.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.90 / $42.66	Professional	TC	$26.30	$30.90	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $275.42 / $501.19	Facility		$109.65	$275.42	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $36.31 / $47.86	Professional		$20.89	$36.31	$47.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.18 / $18.20	Professional	26	$9.12	$13.18	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $22.39 / $30.20	Professional	TC	$10.96	$22.39	$30.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $81.28 / $81.28	Professional		$60.26	$81.28	$81.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $60.26 / $60.26	Professional	26	$51.29	$60.26	$60.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $20.42 / $20.42	Professional	TC	$20.42	$20.42	$20.42
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $66.07 / $323.59	Facility		$26.92	$66.07	$323.59
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $21.88 / $26.92	Facility	26	$12.59	$21.88	$26.92
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $263.03 / $630.96	Facility	TC	$38.02	$263.03	$630.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $47.86 / $66.07	Professional		$20.89	$47.86	$66.07
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $14.45 / $26.92	Professional	26	$8.13	$14.45	$26.92
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $29.51 / $38.02	Professional	TC	$11.75	$29.51	$38.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $19.95 / $33.11	Professional		$6.92	$19.95	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $218.78 / $309.03	Facility		$158.49	$218.78	$309.03
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	TC	$158.49	$158.49	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $61.66	Professional		$33.88	$51.29	$61.66
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.98 / $21.88	Professional	26	$13.80	$16.98	$21.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $33.11 / $40.74	Professional	TC	$18.20	$33.11	$40.74
Select Health Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $61.66	Professional		$23.44	$23.44	$61.66
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $18.20	Professional	26	$7.94	$7.94	$18.20
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $15.85 / $36.31	Professional	TC	$15.49	$15.85	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.70 / $45.71	Professional		$19.05	$25.70	$45.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.55 / $17.78	Professional	26	$8.91	$9.55	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $16.60 / $28.18	Professional	TC	$10.23	$16.60	$28.18