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 $354.81 / $478.63 / $1,202.26	Professional		$354.81	$478.63	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $138.04 / $338.84	Professional	26	$85.11	$138.04	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $363.08 / $912.01	Professional	TC	$257.04	$363.08	$912.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $630.96 / $870.96	Professional		$562.34	$630.96	$870.96
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 $426.58 / $467.74 / $645.65	Professional	TC	$426.58	$467.74	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $489.78 / $870.96	Professional		$295.12	$489.78	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $100.00 / $177.83	Professional	26	$70.79	$100.00	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $371.54 / $645.65	Professional	TC	$223.87	$371.54	$645.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,905.46	Professional		$1,737.80	$1,737.80	$1,905.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $524.81 / $630.96 / $630.96	Professional	26	$524.81	$630.96	$630.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,096.48 / $1,096.48 / $1,412.54	Professional	TC	$1,096.48	$1,096.48	$1,412.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $660.69 / $1,071.52	Professional		$478.63	$660.69	$1,071.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $162.18 / $229.09	Professional	26	$117.49	$162.18	$229.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $501.19 / $912.01	Professional	TC	$338.84	$501.19	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $851.14	Professional		$524.81	$707.95	$851.14
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 $371.54 / $537.03 / $691.83	Professional	TC	$371.54	$537.03	$691.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $1,096.48	Professional		$309.03	$309.03	$1,096.48
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 $234.42 / $234.42 / $562.34	Professional	TC	$234.42	$234.42	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $977.24	Professional		$331.13	$467.74	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $91.20 / $181.97	Professional	26	$74.13	$91.20	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $371.54 / $812.83	Professional	TC	$257.04	$371.54	$812.83