Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $16.98 / $30.90	Facility	26	$16.98	$16.98	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $45.71 / $89.13	Professional		$35.48	$45.71	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.96 / $25.12	Professional	26	$8.91	$10.96	$25.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $35.48 / $64.57	Professional	TC	$25.12	$35.48	$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 $69.18 / $81.28 / $112.20	Professional		$69.18	$81.28	$112.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.39 / $30.90	Professional	26	$19.05	$22.39	$30.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $58.88 / $83.18	Professional	TC	$50.12	$58.88	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $85.11	Professional		$43.65	$63.10	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.20 / $23.44	Professional	26	$11.75	$18.20	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $46.77 / $63.10	Professional	TC	$28.84	$46.77	$63.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $162.18	Professional		$144.54	$144.54	$162.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $66.07	Professional	26	$64.57	$64.57	$66.07
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $81.28 / $95.50	Professional	TC	$81.28	$81.28	$95.50
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $16.98 / $30.20	Facility	26	$16.98	$16.98	$30.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $83.18 / $102.33	Professional		$44.67	$83.18	$102.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $21.38 / $25.70	Professional	26	$10.00	$21.38	$25.70
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $61.66 / $74.13	Professional	TC	$33.11	$61.66	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $32.36 / $33.11	Professional		$9.33	$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 $74.13 / $89.13 / $107.15	Professional		$74.13	$89.13	$107.15
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $23.44 / $29.51	Professional	26	$17.78	$23.44	$29.51
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $64.57 / $77.62	Professional	TC	$54.95	$64.57	$77.62
Select Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $41.69 / $107.15	Professional		$40.74	$41.69	$107.15
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $10.96 / $25.70	Professional	26	$10.96	$10.96	$25.70
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $36.31 / $69.18	Professional	TC	$30.20	$36.31	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $45.71 / $87.10	Professional		$43.65	$45.71	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.59 / $23.99	Professional	26	$10.47	$12.59	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $34.67 / $64.57	Professional	TC	$30.90	$34.67	$64.57