Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $223.87 / $354.81	Facility		$79.43	$223.87	$354.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $25.70 / $30.20	Facility	26	$13.49	$25.70	$30.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $54.95 / $269.15 / $549.54	Facility	TC	$54.95	$269.15	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $52.48 / $173.78	Professional		$28.84	$52.48	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.98 / $54.95	Professional	26	$9.55	$16.98	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $57.54	Professional	TC	$19.05	$28.18	$57.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $181.97 / $269.15	Facility		$69.18	$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 $37.15 / $37.15 / $158.49	Facility	TC	$37.15	$37.15	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $61.66 / $85.11	Professional		$52.48	$61.66	$85.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $19.50 / $27.54	Professional	26	$16.60	$19.50	$27.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $41.69 / $57.54	Professional	TC	$35.48	$41.69	$57.54
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 $31.62 / $47.86 / $63.10	Professional		$31.62	$47.86	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.85 / $21.88	Professional	26	$10.72	$15.85	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $31.62 / $41.69	Professional	TC	$19.95	$31.62	$41.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $218.78	Professional		$102.33	$102.33	$218.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	26	$69.18	$69.18	$69.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $32.36 / $169.82	Professional	TC	$32.36	$32.36	$169.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $89.13 / $331.13	Facility		$35.48	$89.13	$331.13
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $26.30 / $33.11	Facility	26	$15.14	$26.30	$33.11
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $53.70 / $239.88 / $389.05	Facility	TC	$53.70	$239.88	$389.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $56.23 / $93.33	Professional		$29.51	$56.23	$93.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $19.05 / $33.11	Professional	26	$9.77	$19.05	$33.11
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $40.74 / $57.54	Professional	TC	$19.95	$40.74	$57.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $25.70 / $33.11	Professional		$8.32	$25.70	$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 $51.29 / $67.61 / $81.28	Professional		$51.29	$67.61	$81.28
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.89 / $26.30	Professional	26	$16.98	$20.89	$26.30
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $45.71 / $54.95	Professional	TC	$32.36	$45.71	$54.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $81.28	Professional		$30.90	$30.90	$81.28
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $9.55 / $22.91	Professional	26	$9.55	$9.55	$22.91
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $21.88 / $48.98	Professional	TC	$20.89	$21.88	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.88 / $63.10	Professional		$29.51	$33.88	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $11.48 / $21.38	Professional	26	$10.47	$11.48	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $21.88 / $41.69	Professional	TC	$18.62	$21.88	$41.69