Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $31.62 / $33.88	Facility	26	$16.60	$31.62	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $120.23	Professional		$27.54	$50.12	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $19.50 / $39.81	Professional	26	$10.96	$19.50	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $40.74 / $64.57	Professional	TC	$23.99	$40.74	$64.57
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $107.15	Professional		$64.57	$75.86	$107.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $23.99 / $33.88	Professional	26	$20.42	$23.99	$33.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.48 / $72.44	Professional	TC	$44.67	$52.48	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $60.26 / $79.43	Professional		$38.90	$60.26	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $19.50 / $27.54	Professional	26	$13.49	$19.50	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $39.81 / $52.48	Professional	TC	$24.55	$39.81	$52.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $131.83	Professional		$123.03	$123.03	$131.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $64.57	Professional	26	$61.66	$61.66	$64.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $60.26 / $66.07	Professional	TC	$60.26	$60.26	$66.07
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $32.36 / $33.88	Facility	26	$18.62	$32.36	$33.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $75.86 / $102.33	Professional		$38.02	$75.86	$102.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $23.99 / $35.48	Professional	26	$12.02	$23.99	$35.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $51.29 / $64.57	Professional	TC	$27.54	$51.29	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $32.36 / $33.11	Professional		$10.23	$32.36	$33.11
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $83.18 / $102.33	Professional		$63.10	$83.18	$102.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.12 / $32.36	Professional	26	$20.89	$25.12	$32.36
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $57.54 / $69.18	Professional	TC	$41.69	$57.54	$69.18
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $39.81 / $102.33	Professional		$38.90	$39.81	$102.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $12.02 / $28.18	Professional	26	$12.02	$12.02	$28.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $32.36 / $61.66	Professional	TC	$26.30	$32.36	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $83.18	Professional		$39.81	$41.69	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $13.80 / $27.54	Professional	26	$12.88	$13.80	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $28.18 / $52.48	Professional	TC	$26.30	$28.18	$52.48