Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $23.99 / $25.12	Facility	26	$19.95	$23.99	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.90 / $85.11	Professional		$22.91	$38.90	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.23 / $23.44	Professional	26	$7.08	$10.23	$23.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $25.70 / $52.48	Professional	TC	$15.14	$25.70	$52.48
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 Professional Modifier Low / Median / High Price $44.67 / $52.48 / $74.13	Professional		$44.67	$52.48	$74.13
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 $30.20 / $35.48 / $50.12	Professional	TC	$30.20	$35.48	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $45.71 / $72.44	Professional		$34.67	$45.71	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.13 / $21.38	Professional	26	$10.47	$14.13	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $51.29	Professional	TC	$22.91	$30.90	$51.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $120.23	Professional		$109.65	$109.65	$120.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $51.29 / $51.29	Professional	26	$42.66	$51.29	$51.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $57.54 / $79.43	Professional	TC	$57.54	$57.54	$79.43
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $23.99	Facility	26	$19.95	$19.95	$23.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $75.86	Professional		$33.88	$57.54	$75.86
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $17.78 / $21.88	Professional	26	$9.33	$17.78	$21.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $39.81 / $53.70	Professional	TC	$22.91	$39.81	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $22.39 / $33.11	Professional		$7.24	$22.39	$33.11
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 Professional Modifier Low / Median / High Price $47.86 / $57.54 / $75.86	Professional		$47.86	$57.54	$75.86
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.62 / $22.39	Professional	26	$14.79	$18.62	$22.39
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $40.74 / $54.95	Professional	TC	$33.11	$40.74	$54.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.84 / $69.18	Professional		$28.18	$28.84	$69.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $8.91 / $19.95	Professional	26	$8.91	$8.91	$19.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $21.88 / $42.66	Professional	TC	$19.05	$21.88	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $77.62	Professional		$31.62	$40.74	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $11.22 / $21.38	Professional	26	$9.77	$11.22	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $56.23	Professional	TC	$21.88	$30.20	$56.23