Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $295.12 / $346.74	Facility		$42.66	$295.12	$346.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $20.42 / $26.92	Facility	26	$10.96	$20.42	$26.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $323.59 / $407.38	Facility	TC	$38.02	$323.59	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $36.31 / $69.18	Professional		$24.55	$36.31	$69.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $13.49 / $34.67	Professional	26	$7.76	$13.49	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $43.65	Professional	TC	$15.85	$22.91	$43.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $194.98 / $354.81	Facility		$69.18	$194.98	$354.81
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $30.90 / $213.80	Facility	TC	$30.90	$30.90	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $51.29 / $70.79	Professional		$43.65	$51.29	$70.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.85 / $21.88	Professional	26	$13.49	$15.85	$21.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $35.48 / $48.98	Professional	TC	$30.20	$35.48	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $371.54 / $602.56	Facility		$147.91	$371.54	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $40.74 / $63.10	Professional		$27.54	$40.74	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.18 / $17.78	Professional	26	$8.71	$13.18	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.84 / $44.67	Professional	TC	$16.98	$28.84	$44.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $117.49	Professional		$95.50	$95.50	$117.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	26	$60.26	$60.26	$60.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $58.88	Professional	TC	$37.15	$37.15	$58.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $51.29 / $295.12	Facility		$25.70	$51.29	$295.12
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $21.38 / $26.92	Facility	26	$12.30	$21.38	$26.92
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $194.98 / $407.38	Facility	TC	$38.02	$194.98	$407.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $52.48 / $67.61	Professional		$26.92	$52.48	$67.61
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.85 / $23.44	Professional	26	$7.94	$15.85	$23.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $36.31 / $43.65	Professional	TC	$18.62	$36.31	$43.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $21.38 / $33.11	Professional		$6.61	$21.38	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $263.03 / $380.19	Facility		$213.80	$263.03	$380.19
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	TC	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $54.95 / $67.61	Professional		$43.65	$54.95	$67.61
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.60 / $20.89	Professional	26	$13.80	$16.60	$20.89
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $38.02 / $45.71	Professional	TC	$29.51	$38.02	$45.71
Select Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $26.92 / $67.61	Professional		$25.70	$26.92	$67.61
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $18.20	Professional	26	$7.94	$7.94	$18.20
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $21.38 / $40.74	Professional	TC	$17.78	$21.38	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $30.20 / $57.54	Professional		$27.54	$30.20	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.12 / $18.20	Professional	26	$8.91	$9.12	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $20.89 / $39.81	Professional	TC	$18.20	$20.89	$39.81