Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $870.96	Professional		$281.84	$478.63	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $269.15	Professional	26	$85.11	$141.25	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $316.23 / $588.84	Professional	TC	$199.53	$316.23	$588.84
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 $457.09 / $501.19 / $691.83	Professional		$457.09	$501.19	$691.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $158.49 / $223.87	Professional	26	$134.90	$158.49	$223.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $338.84 / $478.63	Professional	TC	$316.23	$338.84	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $389.05 / $776.25	Professional		$234.42	$389.05	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $100.00 / $181.97	Professional	26	$70.79	$100.00	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $275.42 / $616.60	Professional	TC	$165.96	$275.42	$616.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,905.46	Professional		$1,698.24	$1,698.24	$1,905.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $354.81 / $758.58 / $758.58	Professional	26	$354.81	$758.58	$758.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $954.99 / $954.99 / $1,548.82	Professional	TC	$954.99	$954.99	$1,548.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $537.03 / $912.01	Professional		$446.68	$537.03	$912.01
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $162.18 / $229.09	Professional	26	$120.23	$162.18	$229.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $371.54 / $691.83	Professional	TC	$302.00	$371.54	$691.83
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 $426.58 / $575.44 / $870.96	Professional		$426.58	$575.44	$870.96
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 $275.42 / $407.38 / $707.95	Professional	TC	$275.42	$407.38	$707.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $257.04 / $954.99	Professional		$251.19	$257.04	$954.99
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $186.21	Professional	26	$79.43	$79.43	$186.21
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $194.98 / $891.25	Professional	TC	$173.78	$194.98	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $457.09 / $977.24	Professional		$269.15	$457.09	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $91.20 / $173.78	Professional	26	$74.13	$91.20	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $354.81 / $794.33	Professional	TC	$190.55	$354.81	$794.33