Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $23.99 / $23.99	Facility	26	$19.95	$23.99	$23.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $54.95 / $194.98 / $549.54	Facility	TC	$54.95	$194.98	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $109.65	Professional		$25.12	$38.02	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $32.36	Professional	26	$7.08	$10.00	$32.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.44 / $52.48	Professional	TC	$18.20	$23.44	$52.48
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 $51.29 / $60.26 / $85.11	Professional		$51.29	$60.26	$85.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.98 / $23.44	Professional	26	$14.45	$16.98	$23.44
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 Professional Modifier Low / Median / High Price $30.90 / $46.77 / $60.26	Professional		$30.90	$46.77	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.80 / $19.05	Professional	26	$9.33	$13.80	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $41.69	Professional	TC	$20.42	$31.62	$41.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $107.15 / $107.15	Professional		$100.00	$107.15	$107.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $45.71 / $45.71	Professional	26	$40.74	$45.71	$45.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $63.10 / $63.10	Professional	TC	$63.10	$63.10	$63.10
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $22.91 / $23.99	Facility	26	$19.95	$22.91	$23.99
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $54.95 / $144.54 / $549.54	Facility	TC	$54.95	$144.54	$549.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $58.88 / $79.43	Professional		$28.84	$58.88	$79.43
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $16.98 / $24.55	Professional	26	$8.71	$16.98	$24.55
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $44.67 / $54.95	Professional	TC	$19.95	$44.67	$54.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $25.70 / $33.11	Professional		$7.24	$25.70	$33.11
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 $48.98 / $64.57 / $79.43	Professional		$48.98	$64.57	$79.43
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.20 / $22.39	Professional	26	$14.79	$18.20	$22.39
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $45.71 / $56.23	Professional	TC	$33.11	$45.71	$56.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $72.44	Professional		$30.90	$30.90	$72.44
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $8.71 / $19.95	Professional	26	$8.71	$8.71	$19.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $23.44 / $50.12	Professional	TC	$22.39	$23.44	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $60.26	Professional		$28.18	$33.11	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $10.00 / $18.62	Professional	26	$9.12	$10.00	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $22.39 / $42.66	Professional	TC	$19.05	$22.39	$42.66