Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $275.42 / $549.54	Facility		$45.71	$275.42	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $16.98 / $20.42	Facility	26	$10.00	$16.98	$20.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $45.71 / $281.84 / $562.34	Facility	TC	$45.71	$281.84	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $38.90 / $93.33	Professional		$17.38	$38.90	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $15.85 / $40.74	Professional	26	$7.08	$15.85	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	50	$56.23	$56.23	$56.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $33.11 / $48.98	Professional	TC	$17.38	$33.11	$48.98
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 $33.88 / $33.88 / $158.49	Facility	TC	$33.88	$33.88	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $74.13	Professional		$45.71	$53.70	$74.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.45 / $20.42	Professional	26	$12.30	$14.45	$20.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $38.90 / $53.70	Professional	TC	$33.11	$38.90	$53.70
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 $26.92 / $41.69 / $53.70	Professional		$26.92	$41.69	$53.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.75 / $16.98	Professional	26	$8.32	$11.75	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $38.90	Professional	TC	$18.20	$28.84	$38.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $123.03	Professional		$89.13	$89.13	$123.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Professional	26	$53.70	$53.70	$53.70
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $70.79	Professional	TC	$35.48	$35.48	$70.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $52.48 / $288.40	Facility		$27.54	$52.48	$288.40
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $19.50 / $20.42	Facility	26	$11.22	$19.50	$20.42
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $45.71 / $257.04 / $549.54	Facility	TC	$45.71	$257.04	$549.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $51.29 / $79.43	Professional		$23.99	$51.29	$79.43
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $15.14 / $22.39	Professional	26	$7.41	$15.14	$22.39
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $38.90 / $47.86	Professional	TC	$20.42	$38.90	$47.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $22.39 / $33.11	Professional		$6.17	$22.39	$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 $44.67 / $57.54 / $70.79	Professional		$44.67	$57.54	$70.79
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.49 / $19.05	Professional	26	$12.59	$15.49	$19.05
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $42.66 / $51.29	Professional	TC	$31.62	$42.66	$51.29
Select Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $27.54 / $70.79	Professional		$26.92	$27.54	$70.79
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.41 / $16.98	Professional	26	$7.41	$7.41	$16.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.44 / $44.67	Professional	TC	$19.50	$23.44	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $29.51 / $58.88	Professional		$27.54	$29.51	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $8.71 / $17.38	Professional	26	$7.76	$8.71	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $20.89 / $39.81	Professional	TC	$19.50	$20.89	$39.81