Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $36.31	Facility	26	$34.67	$34.67	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $104.71	Professional		$34.67	$46.77	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.14 / $34.67	Professional	26	$10.96	$15.14	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $32.36 / $70.79	Professional	TC	$23.44	$32.36	$70.79
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 $67.61 / $79.43 / $112.20	Professional		$67.61	$79.43	$112.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $26.30 / $36.31	Professional	26	$22.39	$26.30	$36.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $53.70 / $74.13	Professional	TC	$45.71	$53.70	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $63.10 / $81.28	Professional		$39.81	$63.10	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $20.89 / $29.51	Professional	26	$14.45	$20.89	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $40.74 / $53.70	Professional	TC	$25.70	$40.74	$53.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $141.25	Professional		$125.89	$125.89	$141.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $95.50	Professional	26	$70.79	$70.79	$95.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $56.23 / $56.23	Professional	TC	$46.77	$56.23	$56.23
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $81.28 / $107.15	Professional		$43.65	$81.28	$107.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $25.12 / $33.88	Professional	26	$13.18	$25.12	$33.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $56.23 / $64.57	Professional	TC	$28.84	$56.23	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $32.36 / $33.11	Professional		$10.96	$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 $67.61 / $87.10 / $107.15	Professional		$67.61	$87.10	$107.15
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $27.54 / $34.67	Professional	26	$21.88	$27.54	$34.67
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $58.88 / $70.79	Professional	TC	$45.71	$58.88	$70.79
Select Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $40.74 / $107.15	Professional		$39.81	$40.74	$107.15
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $12.88 / $30.20	Professional	26	$12.88	$12.88	$30.20
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $33.11 / $63.10	Professional	TC	$26.92	$33.11	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $44.67 / $85.11	Professional		$41.69	$44.67	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $15.14 / $28.84	Professional	26	$13.18	$15.14	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $30.20 / $54.95	Professional	TC	$26.92	$30.20	$54.95