Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $645.65	Professional		$199.53	$338.84	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $173.78	Professional	26	$56.23	$70.79	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $245.47 / $416.87	Professional	TC	$141.25	$245.47	$416.87
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $363.08 / $512.86	Professional		$331.13	$363.08	$512.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $112.20 / $154.88	Professional	26	$104.71	$112.20	$154.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $251.19 / $354.81	Professional	TC	$229.09	$251.19	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $288.40 / $549.54	Professional		$165.96	$288.40	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $75.86 / $128.82	Professional	26	$48.98	$75.86	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $199.53 / $407.38	Professional	TC	$117.49	$199.53	$407.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,202.26	Professional		$1,096.48	$1,096.48	$1,202.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $524.81 / $524.81 / $524.81	Professional	26	$524.81	$524.81	$524.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $562.34 / $562.34 / $691.83	Professional	TC	$562.34	$562.34	$691.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $602.56	Professional		$263.03	$389.05	$602.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $114.82 / $151.36	Professional	26	$63.10	$114.82	$151.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $457.09	Professional	TC	$190.55	$275.42	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $416.87 / $575.44	Professional		$316.23	$416.87	$575.44
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $120.23 / $151.36	Professional	26	$95.50	$120.23	$151.36
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $302.00 / $457.09	Professional	TC	$204.17	$302.00	$457.09
Select Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $186.21 / $676.08	Professional		$181.97	$186.21	$676.08
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $131.83	Professional	26	$54.95	$54.95	$131.83
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $144.54 / $457.09	Professional	TC	$125.89	$144.54	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $660.69	Professional		$199.53	$302.00	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $70.79 / $141.25	Professional	26	$57.54	$70.79	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $245.47 / $512.86	Professional	TC	$141.25	$245.47	$512.86