Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $281.84 / $446.68	Facility		$56.23	$281.84	$446.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $18.62 / $22.39	Facility	26	$10.96	$18.62	$22.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $56.23 / $275.42 / $562.34	Facility	TC	$56.23	$275.42	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $47.86 / $131.83	Professional		$18.62	$47.86	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $16.60 / $42.66	Professional	26	$7.41	$16.60	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $79.43 / $213.80	Professional	50	$79.43	$79.43	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $40.74 / $63.10	Professional	TC	$20.89	$40.74	$63.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $186.21 / $269.15	Facility		$85.11	$186.21	$269.15
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 $38.02 / $38.02 / $158.49	Facility	TC	$38.02	$38.02	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $83.18	Professional		$50.12	$58.88	$83.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.85 / $21.88	Professional	26	$13.49	$15.85	$21.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $60.26	Professional	TC	$37.15	$43.65	$60.26
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 $32.36 / $46.77 / $64.57	Professional		$32.36	$46.77	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $17.78	Professional	26	$8.71	$12.88	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.88 / $46.77	Professional	TC	$22.39	$33.88	$46.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $158.49	Professional		$112.20	$112.20	$158.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	26	$58.88	$58.88	$58.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $97.72	Professional	TC	$52.48	$52.48	$97.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $66.07 / $309.03	Facility		$31.62	$66.07	$309.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $20.42 / $22.39	Facility	26	$12.30	$20.42	$22.39
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $239.88 / $549.54	Facility	TC	$46.77	$239.88	$549.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $57.54 / $93.33	Professional		$24.55	$57.54	$93.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $16.22 / $23.99	Professional	26	$7.76	$16.22	$23.99
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $15.49 / $79.43 / $131.83	Professional	50	$15.49	$79.43	$131.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $46.77 / $56.23	Professional	TC	$25.12	$46.77	$56.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $25.12 / $33.11	Professional		$6.61	$25.12	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $218.78 / $309.03	Facility		$147.91	$218.78	$309.03
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 $53.70 / $64.57 / $77.62	Professional		$53.70	$64.57	$77.62
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.60 / $20.89	Professional	26	$13.80	$16.60	$20.89
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $46.77 / $57.54	Professional	TC	$39.81	$46.77	$57.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $31.62 / $97.72	Professional		$30.90	$31.62	$97.72
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $18.20	Professional	26	$7.94	$7.94	$18.20
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.30 / $51.29	Professional	TC	$22.39	$26.30	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $34.67 / $64.57	Professional		$31.62	$34.67	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.12 / $17.78	Professional	26	$8.51	$9.12	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.30 / $48.98	Professional	TC	$22.39	$26.30	$48.98