Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $275.42 / $549.54	Facility		$63.10	$275.42	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $22.91 / $28.84	Facility	26	$11.75	$22.91	$28.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $58.88 / $281.84 / $575.44	Facility	TC	$58.88	$281.84	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $43.65 / $100.00	Professional		$20.89	$43.65	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.14 / $50.12	Professional	26	$8.32	$15.14	$50.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $87.10 / $125.89	Professional	50	$25.70	$87.10	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.90 / $83.18	Professional	TC	$20.89	$38.90	$83.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $186.21 / $309.03	Facility		$85.11	$186.21	$309.03
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $39.81 / $158.49	Facility	TC	$39.81	$39.81	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $63.10 / $87.10	Professional		$53.70	$63.10	$87.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.98 / $23.44	Professional	26	$14.45	$16.98	$23.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $45.71 / $64.57	Professional	TC	$38.90	$45.71	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $275.42 / $501.19	Facility		$109.65	$275.42	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $48.98 / $63.10	Professional		$29.51	$48.98	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $19.05	Professional	26	$9.33	$14.13	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $34.67 / $45.71	Professional	TC	$19.50	$34.67	$45.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $186.21	Professional		$104.71	$104.71	$186.21
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 $44.67 / $44.67 / $123.03	Professional	TC	$44.67	$44.67	$123.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $75.86 / $363.08	Facility		$33.11	$75.86	$363.08
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $22.91 / $28.84	Facility	26	$13.18	$22.91	$28.84
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $52.48 / $263.03 / $562.34	Facility	TC	$52.48	$263.03	$562.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $58.88 / $97.72	Professional		$25.70	$58.88	$97.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $16.98 / $28.18	Professional	26	$8.71	$16.98	$28.18
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $18.20 / $70.79 / $117.49	Professional	50	$18.20	$70.79	$117.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $46.77 / $74.13	Professional	TC	$22.91	$46.77	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $26.30 / $33.11	Professional		$7.24	$26.30	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $239.88 / $316.23	Facility		$158.49	$239.88	$316.23
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	TC	$158.49	$158.49	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $83.18	Professional		$48.98	$67.61	$83.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.20 / $22.39	Professional	26	$14.79	$18.20	$22.39
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $50.12 / $60.26	Professional	TC	$35.48	$50.12	$60.26
Select Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.88 / $83.18	Professional		$33.11	$33.88	$83.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $8.71 / $19.95	Professional	26	$8.71	$8.71	$19.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $28.18 / $52.48	Professional	TC	$24.55	$28.18	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.88 / $64.57	Professional		$31.62	$33.88	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.00 / $19.50	Professional	26	$9.77	$10.00	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $23.99 / $44.67	Professional	TC	$21.88	$23.99	$44.67