Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $158.49 / $416.87	Facility	26	$141.25	$158.49	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $537.03 / $1,380.38	Professional		$346.74	$537.03	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $173.78 / $389.05	Professional	26	$107.15	$173.78	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $338.84 / $776.25	Professional	TC	$223.87	$338.84	$776.25
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 $537.03 / $588.84 / $831.76	Professional		$537.03	$588.84	$831.76
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $204.17 / $288.40	Professional	26	$173.78	$204.17	$288.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $389.05 / $549.54	Professional	TC	$363.08	$389.05	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $467.74 / $933.25	Professional		$281.84	$467.74	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $134.90 / $229.09	Professional	26	$91.20	$134.90	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $316.23 / $741.31	Professional	TC	$190.55	$316.23	$741.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,630.27	Professional		$2,344.23	$2,344.23	$2,630.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $891.25 / $891.25 / $891.25	Professional	26	$891.25	$891.25	$891.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,479.11 / $1,479.11 / $1,737.80	Professional	TC	$1,479.11	$1,479.11	$1,737.80
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $363.08 / $512.86	Facility	26	$141.25	$363.08	$512.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $630.96 / $1,122.02	Professional		$446.68	$630.96	$1,122.02
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $208.93 / $295.12	Professional	26	$123.03	$208.93	$295.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $426.58 / $758.58	Professional	TC	$302.00	$426.58	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $213.80	Professional		$32.36	$33.11	$213.80
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 $524.81 / $676.08 / $954.99	Professional		$524.81	$676.08	$954.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $218.78 / $275.42	Professional	26	$177.83	$218.78	$275.42
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $467.74 / $724.44	Professional	TC	$316.23	$467.74	$724.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $302.00 / $1,318.26	Professional		$295.12	$302.00	$1,318.26
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $100.00 / $257.04	Professional	26	$100.00	$100.00	$257.04
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $223.87 / $912.01	Professional	TC	$194.98	$223.87	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $524.81 / $1,148.15	Professional		$316.23	$524.81	$1,148.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $123.03 / $234.42	Professional	26	$100.00	$123.03	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $407.38 / $870.96	Professional	TC	$218.78	$407.38	$870.96