Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $389.05	Facility	26	$131.83	$131.83	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $524.81 / $1,348.96	Professional		$281.84	$524.81	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $154.88 / $407.38	Professional	26	$102.33	$154.88	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $436.52 / $1,000.00	Professional	TC	$316.23	$436.52	$1,000.00
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 $691.83 / $758.58 / $1,047.13	Professional		$691.83	$758.58	$1,047.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $190.55 / $269.15	Professional	26	$162.18	$190.55	$269.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $562.34 / $776.25	Professional	TC	$537.03	$562.34	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $588.84 / $1,096.48	Professional		$363.08	$588.84	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $120.23 / $204.17	Professional	26	$85.11	$120.23	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $398.11 / $912.01	Professional	TC	$275.42	$398.11	$912.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,187.76 / $2,187.76	Professional		$1,202.26	$2,187.76	$2,187.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $741.31 / $741.31 / $741.31	Professional	26	$741.31	$741.31	$741.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $1,445.44 / $1,445.44	Professional	TC	$457.09	$1,445.44	$1,445.44
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $389.05 / $389.05	Facility	26	$131.83	$389.05	$389.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $794.33 / $1,380.38	Professional		$478.63	$794.33	$1,380.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $194.98 / $281.84	Professional	26	$128.82	$194.98	$281.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $602.56 / $1,000.00	Professional	TC	$346.74	$602.56	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $269.15	Professional		$32.36	$33.11	$269.15
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 $602.56 / $870.96 / $1,047.13	Professional		$602.56	$870.96	$1,047.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $204.17 / $257.04	Professional	26	$165.96	$204.17	$257.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $660.69 / $851.14	Professional	TC	$467.74	$660.69	$851.14
Select Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $389.05 / $1,348.96	Professional		$380.19	$389.05	$1,348.96
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $234.42	Professional	26	$95.50	$95.50	$234.42
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $316.23 / $912.01	Professional	TC	$281.84	$316.23	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $1,230.27	Professional		$416.87	$588.84	$1,230.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $109.65 / $208.93	Professional	26	$89.13	$109.65	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $478.63 / $1,023.29	Professional	TC	$323.59	$478.63	$1,023.29