Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $281.84 / $436.52	Professional		$190.55	$281.84	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $134.90	Professional	26	$53.70	$64.57	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $213.80 / $323.59	Professional	TC	$134.90	$213.80	$323.59
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $363.08 / $512.86	Professional		$346.74	$363.08	$512.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $158.49	Professional	26	$95.50	$112.20	$158.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $251.19 / $354.81	Professional	TC	$239.88	$251.19	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $323.59 / $549.54	Professional		$165.96	$323.59	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $70.79 / $125.89	Professional	26	$50.12	$70.79	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $234.42 / $416.87	Professional	TC	$117.49	$234.42	$416.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,148.15	Professional		$1,023.29	$1,023.29	$1,148.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $457.09 / $457.09	Professional	26	$380.19	$457.09	$457.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $575.44 / $758.58	Professional	TC	$575.44	$575.44	$758.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $389.05 / $549.54	Professional		$208.93	$389.05	$549.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $114.82 / $134.90	Professional	26	$64.57	$114.82	$134.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $275.42 / $407.38	Professional	TC	$199.53	$275.42	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $416.87 / $575.44	Professional		$309.03	$416.87	$575.44
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $120.23 / $151.36	Professional	26	$97.72	$120.23	$151.36
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $302.00 / $457.09	Professional	TC	$204.17	$302.00	$457.09
Select Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $186.21 / $707.95	Professional		$181.97	$186.21	$707.95
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $131.83	Professional	26	$56.23	$56.23	$131.83
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $144.54 / $457.09	Professional	TC	$125.89	$144.54	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $645.65	Professional		$199.53	$302.00	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $128.82	Professional	26	$52.48	$64.57	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $245.47 / $512.86	Professional	TC	$144.54	$245.47	$512.86