Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $144.54	Facility	26	$70.79	$70.79	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $263.03 / $524.81	Professional		$147.91	$263.03	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $158.49	Professional	26	$52.48	$72.44	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $208.93 / $407.38	Professional	TC	$147.91	$208.93	$407.38
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $512.86	Professional		$316.23	$371.54	$512.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $102.33 / $144.54	Professional	26	$89.13	$102.33	$144.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $269.15 / $371.54	Professional	TC	$229.09	$269.15	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $478.63	Professional		$169.82	$275.42	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $64.57 / $117.49	Professional	26	$45.71	$64.57	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $194.98 / $338.84	Professional	TC	$125.89	$194.98	$338.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $912.01	Professional		$831.76	$831.76	$912.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $257.04 / $436.52 / $436.52	Professional	26	$257.04	$436.52	$436.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $389.05 / $660.69	Professional	TC	$389.05	$389.05	$660.69
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $144.54 / $144.54	Facility	26	$70.79	$144.54	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $398.11 / $562.34	Professional		$229.09	$398.11	$562.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $104.71 / $131.83	Professional	26	$57.54	$104.71	$131.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $288.40 / $407.38	Professional	TC	$190.55	$288.40	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $426.58 / $501.19	Professional		$309.03	$426.58	$501.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $109.65 / $138.04	Professional	26	$89.13	$109.65	$138.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $316.23 / $371.54	Professional	TC	$213.80	$316.23	$371.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $190.55 / $549.54	Professional		$186.21	$190.55	$549.54
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $51.29 / $120.23	Professional	26	$51.29	$51.29	$120.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $151.36 / $758.58	Professional	TC	$134.90	$151.36	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $251.19 / $524.81	Professional		$190.55	$251.19	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $58.88 / $117.49	Professional	26	$47.86	$58.88	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $199.53 / $407.38	Professional	TC	$141.25	$199.53	$407.38