Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $31.62 / $33.88	Facility	26	$30.20	$31.62	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $138.04	Professional		$33.88	$46.77	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $39.81	Professional	26	$10.00	$16.98	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $58.88	Professional	TC	$22.91	$30.90	$58.88
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 Professional Modifier Low / Median / High Price $66.07 / $77.62 / $109.65	Professional		$66.07	$77.62	$109.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.44 / $33.11	Professional	26	$19.95	$23.44	$33.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $54.95 / $75.86	Professional	TC	$46.77	$54.95	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $79.43	Professional		$40.74	$60.26	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.05 / $27.54	Professional	26	$13.18	$19.05	$27.54
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 $87.10 / $141.25 / $141.25	Professional		$87.10	$141.25	$141.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	26	$91.20	$91.20	$91.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $51.29 / $91.20	Professional	TC	$51.29	$51.29	$91.20
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $31.62 / $31.62	Facility	26	$30.20	$31.62	$31.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $83.18 / $102.33	Professional		$38.90	$83.18	$102.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $23.99 / $33.88	Professional	26	$12.02	$23.99	$33.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $56.23 / $69.18	Professional	TC	$25.70	$56.23	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $32.36 / $33.11	Professional		$10.00	$32.36	$33.11
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 Professional Modifier Low / Median / High Price $64.57 / $83.18 / $102.33	Professional		$64.57	$83.18	$102.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $24.55 / $30.90	Professional	26	$20.42	$24.55	$30.90
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $58.88 / $70.79	Professional	TC	$41.69	$58.88	$70.79
Select Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $102.33	Professional		$40.74	$40.74	$102.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $12.02 / $27.54	Professional	26	$12.02	$12.02	$27.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $29.51 / $63.10	Professional	TC	$28.84	$29.51	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $79.43	Professional		$37.15	$43.65	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $14.13 / $26.30	Professional	26	$12.88	$14.13	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $28.18 / $53.70	Professional	TC	$23.99	$28.18	$53.70