Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $44.67 / $52.48	Facility	26	$25.70	$44.67	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $208.93	Professional		$74.13	$104.71	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $54.95	Professional	26	$15.85	$20.89	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $177.83	Professional	TC	$54.95	$75.86	$177.83
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 $151.36 / $177.83 / $251.19	Professional		$151.36	$177.83	$251.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $52.48	Professional	26	$32.36	$38.02	$52.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $141.25 / $194.98	Professional	TC	$120.23	$141.25	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $138.04 / $181.97	Professional		$87.10	$138.04	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $30.20 / $41.69	Professional	26	$21.38	$30.20	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $104.71 / $141.25	Professional	TC	$61.66	$104.71	$141.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $323.59	Professional		$295.12	$295.12	$323.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	26	$134.90	$134.90	$134.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	TC	$158.49	$158.49	$158.49
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $44.67 / $51.29	Facility	26	$25.70	$44.67	$51.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $186.21 / $223.87	Professional		$83.18	$186.21	$223.87
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $37.15 / $45.71	Professional	26	$19.05	$37.15	$45.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $151.36 / $173.78	Professional	TC	$64.57	$151.36	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $33.11 / $64.57	Professional		$15.85	$33.11	$64.57
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 $134.90 / $194.98 / $234.42	Professional		$134.90	$194.98	$234.42
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $39.81 / $50.12	Professional	26	$32.36	$39.81	$50.12
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $154.88 / $186.21	Professional	TC	$102.33	$154.88	$186.21
Select Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $213.80	Professional		$91.20	$91.20	$213.80
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.05 / $43.65	Professional	26	$19.05	$19.05	$43.65
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $74.13 / $165.96	Professional	TC	$72.44	$74.13	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $95.50 / $173.78	Professional		$77.62	$95.50	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $21.38 / $40.74	Professional	26	$19.95	$21.38	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $72.44 / $131.83	Professional	TC	$57.54	$72.44	$131.83