Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $223.87	Professional		$79.43	$117.49	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $75.86 / $138.04	Professional	TC	$52.48	$75.86	$138.04
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	26	$1,380.38	$1,380.38	$1,380.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $275.42	Professional		$169.82	$199.53	$275.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $123.03 / $169.82	Professional	TC	$104.71	$123.03	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $239.88	Professional		$109.65	$169.82	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $104.71 / $162.18	Professional	TC	$60.26	$104.71	$162.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $562.34	Professional		$512.86	$512.86	$562.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $338.84 / $338.84	Professional	26	$275.42	$338.84	$338.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $169.82 / $281.84	Professional	TC	$169.82	$169.82	$281.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $208.93 / $309.03	Professional		$125.89	$208.93	$309.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $131.83 / $194.98	Professional	TC	$70.79	$131.83	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $70.79	Professional		$31.62	$33.11	$70.79
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	26	$1,380.38	$1,380.38	$1,380.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $223.87 / $269.15	Professional		$181.97	$223.87	$269.15
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $144.54 / $177.83	Professional	TC	$114.82	$144.54	$177.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $104.71 / $263.03	Professional		$102.33	$104.71	$263.03
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $74.13 / $144.54	Professional	TC	$64.57	$74.13	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $251.19	Professional		$104.71	$134.90	$251.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $93.33 / $177.83	Professional	TC	$63.10	$93.33	$177.83