Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $457.09 / $870.96	Professional		$288.40	$457.09	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $269.15	Professional	26	$85.11	$131.83	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $316.23 / $602.56	Professional	TC	$204.17	$316.23	$602.56
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 $457.09 / $512.86 / $707.95	Professional		$457.09	$512.86	$707.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $162.18 / $223.87	Professional	26	$134.90	$162.18	$223.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $346.74 / $489.78	Professional	TC	$323.59	$346.74	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $398.11 / $794.33	Professional		$239.88	$398.11	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $104.71 / $181.97	Professional	26	$70.79	$104.71	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $630.96	Professional	TC	$169.82	$281.84	$630.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,862.09	Professional		$1,698.24	$1,698.24	$1,862.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $616.60 / $741.31 / $741.31	Professional	26	$616.60	$741.31	$741.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $933.25 / $933.25 / $1,258.93	Professional	TC	$933.25	$933.25	$1,258.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $537.03 / $870.96	Professional		$446.68	$537.03	$870.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $162.18 / $234.42	Professional	26	$112.20	$162.18	$234.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $380.19 / $602.56	Professional	TC	$302.00	$380.19	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $181.97	Professional		$32.36	$33.11	$181.97
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 $436.52 / $588.84 / $891.25	Professional		$436.52	$588.84	$891.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $169.82 / $213.80	Professional	26	$138.04	$169.82	$213.80
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $724.44	Professional	TC	$281.84	$416.87	$724.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $263.03 / $977.24	Professional		$257.04	$263.03	$977.24
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $190.55	Professional	26	$79.43	$79.43	$190.55
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $199.53 / $891.25	Professional	TC	$173.78	$199.53	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $467.74 / $1,000.00	Professional		$275.42	$467.74	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $95.50 / $181.97	Professional	26	$77.62	$95.50	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $363.08 / $812.83	Professional	TC	$194.98	$363.08	$812.83