Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $83.18 / $154.88	Facility	26	$74.13	$83.18	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $501.19	Professional		$173.78	$281.84	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $70.79 / $165.96	Professional	26	$53.70	$70.79	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $199.53 / $338.84	Professional	TC	$114.82	$199.53	$338.84
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $316.23 / $436.52	Professional		$302.00	$316.23	$436.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $109.65 / $151.36	Professional	26	$93.33	$109.65	$151.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $204.17 / $288.40	Professional	TC	$194.98	$204.17	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $275.42 / $457.09	Professional		$141.25	$275.42	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $123.03	Professional	26	$47.86	$67.61	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $199.53 / $331.13	Professional	TC	$93.33	$199.53	$331.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,202.26	Professional		$1,023.29	$1,023.29	$1,202.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Professional	26	$467.74	$467.74	$467.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $562.34 / $562.34 / $724.44	Professional	TC	$562.34	$562.34	$724.44
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $83.18 / $154.88	Facility	26	$74.13	$83.18	$154.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $331.13 / $501.19	Professional		$234.42	$331.13	$501.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $112.20 / $134.90	Professional	26	$60.26	$112.20	$134.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $223.87 / $363.08	Professional	TC	$154.88	$223.87	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $112.20	Professional		$32.36	$33.11	$112.20
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $354.81 / $478.63	Professional		$263.03	$354.81	$478.63
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $114.82 / $144.54	Professional	26	$93.33	$114.82	$144.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $245.47 / $371.54	Professional	TC	$162.18	$245.47	$371.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $162.18 / $575.44	Professional		$158.49	$162.18	$575.44
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $125.89	Professional	26	$53.70	$53.70	$125.89
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $117.49 / $758.58	Professional	TC	$102.33	$117.49	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $537.03	Professional		$169.82	$251.19	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $63.10 / $125.89	Professional	26	$50.12	$63.10	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $199.53 / $416.87	Professional	TC	$114.82	$199.53	$416.87