Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $21.38 / $21.38	Facility	26	$21.38	$21.38	$21.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $50.12 / $50.12 / $54.95	Facility	TC	$50.12	$50.12	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.20 / $66.07	Professional		$21.88	$30.20	$66.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.51 / $22.91	Professional	26	$6.03	$8.51	$22.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $20.89 / $41.69	Professional	TC	$15.85	$20.89	$41.69
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 $33.88 / $33.88 / $158.49	Facility	TC	$33.88	$33.88	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $75.86	Professional		$45.71	$53.70	$75.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.14 / $20.89	Professional	26	$12.88	$15.14	$20.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $38.90 / $53.70	Professional	TC	$33.11	$38.90	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $41.69 / $54.95	Professional		$28.84	$41.69	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.30 / $16.98	Professional	26	$8.32	$12.30	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.84 / $38.90	Professional	TC	$19.50	$28.84	$38.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $102.33	Professional		$61.66	$102.33	$102.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Professional	26	$46.77	$46.77	$46.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	TC	$54.95	$54.95	$54.95
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	TC	$50.12	$50.12	$50.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $56.23 / $70.79	Professional		$26.92	$56.23	$70.79
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $15.14 / $37.15	Professional	26	$7.76	$15.14	$37.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $40.74 / $47.86	Professional	TC	$19.05	$40.74	$47.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $22.91 / $33.11	Professional		$6.31	$22.91	$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 $45.71 / $58.88 / $70.79	Professional		$45.71	$58.88	$70.79
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $15.85 / $19.95	Professional	26	$13.18	$15.85	$19.95
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $42.66 / $50.12	Professional	TC	$31.62	$42.66	$50.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $26.92 / $70.79	Professional		$26.92	$26.92	$70.79
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $7.59 / $17.38	Professional	26	$7.59	$7.59	$17.38
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $19.95 / $44.67	Professional	TC	$19.50	$19.95	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.90 / $56.23	Professional		$26.30	$30.90	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.91 / $16.60	Professional	26	$8.13	$8.91	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $21.38 / $39.81	Professional	TC	$18.20	$21.38	$39.81