Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $104.71 / $125.89	Facility	26	$61.66	$104.71	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $186.21 / $457.09	Professional		$87.10	$186.21	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $85.11 / $218.78	Professional	26	$44.67	$85.11	$218.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	50	$354.81	$354.81	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $177.83 / $398.11	Professional	TC	$102.33	$177.83	$398.11
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $398.11	Professional		$245.47	$288.40	$398.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $89.13 / $123.03	Professional	26	$75.86	$89.13	$123.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $194.98 / $275.42	Professional	TC	$165.96	$194.98	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $416.87	Professional		$138.04	$223.87	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $58.88 / $112.20	Professional	26	$39.81	$58.88	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $154.88 / $295.12	Professional	TC	$97.72	$154.88	$295.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $912.01	Professional		$741.31	$741.31	$912.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $380.19 / $380.19	Professional	26	$380.19	$380.19	$380.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $524.81	Professional	TC	$354.81	$354.81	$524.81
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $112.20 / $125.89	Facility	26	$69.18	$112.20	$125.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $302.00 / $446.68	Professional		$151.36	$302.00	$446.68
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $91.20 / $128.82	Professional	26	$51.29	$91.20	$128.82
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	50	$354.81	$354.81	$354.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $223.87 / $338.84	Professional	TC	$131.83	$223.87	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $346.74 / $407.38	Professional		$257.04	$346.74	$407.38
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $93.33 / $120.23	Professional	26	$77.62	$93.33	$120.23
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $251.19 / $309.03	Professional	TC	$169.82	$251.19	$309.03
Select Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $144.54 / $457.09	Professional		$141.25	$144.54	$457.09
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $104.71	Professional	26	$44.67	$44.67	$104.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $117.49 / $275.42	Professional	TC	$97.72	$117.49	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $426.58	Professional		$154.88	$208.93	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $53.70 / $102.33	Professional	26	$42.66	$53.70	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $154.88 / $323.59	Professional	TC	$109.65	$154.88	$323.59