Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $100.00 / $426.58	Facility		$56.23	$100.00	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $22.91 / $27.54	Facility	26	$14.13	$22.91	$27.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $72.44 / $346.74	Facility	TC	$42.66	$72.44	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $120.23	Professional		$33.88	$51.29	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $41.69	Professional	26	$7.94	$12.02	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $38.02 / $177.83	Professional	50	$38.02	$38.02	$177.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	52	$17.78	$17.78	$17.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $70.79	Professional	TC	$23.99	$32.36	$70.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $234.42 / $380.19	Facility		$117.49	$234.42	$380.19
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 Facility Modifier TC Low / Median / High Price $47.86 / $47.86 / $213.80	Facility	TC	$47.86	$47.86	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $104.71	Professional		$64.57	$75.86	$104.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $20.42 / $28.18	Professional	26	$17.38	$20.42	$28.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $54.95 / $75.86	Professional	TC	$46.77	$54.95	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $371.54 / $602.56	Facility		$147.91	$371.54	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $75.86	Professional		$40.74	$58.88	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.22 / $22.91	Professional	26	$11.22	$16.22	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $54.95	Professional	TC	$26.92	$41.69	$54.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $144.54 / $144.54	Professional		$95.50	$144.54	$144.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	26	$72.44	$72.44	$72.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	TC	$72.44	$72.44	$72.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $63.10 / $302.00	Facility		$33.11	$63.10	$302.00
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $23.99 / $27.54	Facility	26	$15.49	$23.99	$27.54
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $47.86 / $72.44 / $346.74	Facility	TC	$47.86	$72.44	$346.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $72.44 / $100.00	Professional		$38.02	$72.44	$100.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $20.42 / $28.84	Professional	26	$10.47	$20.42	$28.84
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $38.02 / $38.02	Professional	50	$38.02	$38.02	$38.02
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	52	$17.78	$17.78	$17.78
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $58.88 / $72.44	Professional	TC	$27.54	$58.88	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $31.62 / $33.11	Professional		$8.51	$31.62	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $263.03 / $380.19	Facility		$213.80	$263.03	$380.19
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 Facility Modifier TC Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	TC	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $100.00	Professional		$66.07	$81.28	$100.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $21.38 / $26.92	Professional	26	$17.78	$21.38	$26.92
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $60.26 / $72.44	Professional	TC	$45.71	$60.26	$72.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $100.00	Professional		$38.90	$38.90	$100.00
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $23.44	Professional	26	$10.23	$10.23	$23.44
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $29.51 / $64.57	Professional	TC	$28.18	$29.51	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $42.66 / $75.86	Professional		$38.02	$42.66	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.02 / $22.39	Professional	26	$11.22	$12.02	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.20 / $54.95	Professional	TC	$26.30	$30.20	$54.95