Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $27.54 / $28.18	Facility	26	$15.49	$27.54	$28.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $102.33	Professional		$30.90	$45.71	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.85 / $38.02	Professional	26	$7.94	$15.85	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $66.07	Professional	TC	$21.88	$30.90	$66.07
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 Professional Modifier Low / Median / High Price $60.26 / $72.44 / $100.00	Professional		$60.26	$72.44	$100.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $20.42 / $28.18	Professional	26	$17.38	$20.42	$28.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $51.29 / $70.79	Professional	TC	$43.65	$51.29	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $72.44	Professional		$33.88	$56.23	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.60 / $21.38	Professional	26	$10.47	$16.60	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $38.90 / $51.29	Professional	TC	$23.44	$38.90	$51.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $112.20 / $112.20	Professional		$67.61	$112.20	$112.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Professional	26	$61.66	$61.66	$61.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.50 / $52.48 / $52.48	Professional	TC	$5.50	$52.48	$52.48
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $27.54 / $28.84	Facility	26	$15.49	$27.54	$28.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $89.13	Professional		$38.02	$67.61	$89.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $18.62 / $28.18	Professional	26	$9.12	$18.62	$28.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $50.12 / $63.10	Professional	TC	$26.30	$50.12	$63.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $30.20 / $33.11	Professional		$8.51	$30.20	$33.11
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 Professional Modifier Low / Median / High Price $56.23 / $77.62 / $93.33	Professional		$56.23	$77.62	$93.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $21.38 / $26.92	Professional	26	$15.49	$21.38	$26.92
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $56.23 / $67.61	Professional	TC	$40.74	$56.23	$67.61
Select Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $37.15 / $93.33	Professional		$36.31	$37.15	$93.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.00 / $23.44	Professional	26	$10.00	$10.00	$23.44
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $31.62 / $60.26	Professional	TC	$25.70	$31.62	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $38.90 / $72.44	Professional		$35.48	$38.90	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $21.88	Professional	26	$9.12	$12.02	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $27.54 / $52.48	Professional	TC	$25.12	$27.54	$52.48