Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $223.87 / $269.15	Facility	26	$91.20	$223.87	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $501.19 / $1,096.48	Professional		$208.93	$501.19	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $141.25 / $371.54	Professional	26	$69.18	$141.25	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $257.04 / $512.86	Professional	TC	$128.82	$257.04	$512.86
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $354.81 / $489.78	Professional		$316.23	$354.81	$489.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $131.83 / $186.21	Professional	26	$112.20	$131.83	$186.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $223.87 / $309.03	Professional	TC	$204.17	$223.87	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $275.42 / $630.96	Professional		$165.96	$275.42	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $87.10 / $169.82	Professional	26	$58.88	$87.10	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $177.83 / $501.19	Professional	TC	$107.15	$177.83	$501.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,995.26	Professional		$1,479.11	$1,479.11	$1,995.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $575.44 / $575.44 / $575.44	Professional	26	$575.44	$575.44	$575.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $891.25 / $1,412.54	Professional	TC	$891.25	$891.25	$1,412.54
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $263.03 / $281.84	Facility	26	$102.33	$263.03	$281.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $380.19 / $794.33	Professional		$234.42	$380.19	$794.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $134.90 / $208.93	Professional	26	$85.11	$134.90	$208.93
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $245.47 / $588.84	Professional	TC	$186.21	$245.47	$588.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $128.82	Professional		$32.36	$33.11	$128.82
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $407.38 / $691.83	Professional		$309.03	$407.38	$691.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $141.25 / $177.83	Professional	26	$114.82	$141.25	$177.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $263.03 / $562.34	Professional	TC	$177.83	$263.03	$562.34
Select Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $181.97 / $812.83	Professional		$177.83	$181.97	$812.83
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $162.18	Professional	26	$66.07	$66.07	$162.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $125.89 / $630.96	Professional	TC	$112.20	$125.89	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $363.08 / $794.33	Professional		$186.21	$363.08	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $79.43 / $151.36	Professional	26	$64.57	$79.43	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $229.09 / $616.60	Professional	TC	$123.03	$229.09	$616.60