Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $30.20 / $33.11	Facility	26	$16.22	$30.20	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $165.96	Professional		$50.12	$75.86	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.89 / $42.66	Professional	26	$10.96	$20.89	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $46.77 / $91.20	Professional	TC	$32.36	$46.77	$91.20
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 $81.28 / $95.50 / $131.83	Professional		$81.28	$95.50	$131.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $23.99 / $33.88	Professional	26	$20.42	$23.99	$33.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $70.79 / $97.72	Professional	TC	$60.26	$70.79	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $74.13 / $97.72	Professional		$53.70	$74.13	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.95 / $30.20	Professional	26	$14.79	$19.95	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $53.70 / $69.18	Professional	TC	$33.88	$53.70	$69.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $251.19	Professional		$165.96	$165.96	$251.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $100.00 / $100.00	Professional	26	$75.86	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $173.78	Professional	TC	$66.07	$66.07	$173.78
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $31.62 / $33.11	Facility	26	$18.20	$31.62	$33.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $97.72 / $151.36	Professional		$54.95	$97.72	$151.36
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $24.55 / $39.81	Professional	26	$12.88	$24.55	$39.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $70.79 / $91.20	Professional	TC	$38.02	$70.79	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $32.36 / $33.88	Professional		$10.23	$32.36	$33.88
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 $85.11 / $100.00 / $123.03	Professional		$85.11	$100.00	$123.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.12 / $30.90	Professional	26	$20.42	$25.12	$30.90
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $75.86 / $91.20	Professional	TC	$60.26	$75.86	$91.20
Select Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $50.12 / $123.03	Professional		$48.98	$50.12	$123.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $12.02 / $28.18	Professional	26	$12.02	$12.02	$28.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $42.66 / $83.18	Professional	TC	$37.15	$42.66	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $97.72	Professional		$48.98	$51.29	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.49 / $29.51	Professional	26	$13.49	$15.49	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $38.02 / $69.18	Professional	TC	$35.48	$38.02	$69.18