Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $257.04 / $524.81	Facility		$60.26	$257.04	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $20.42 / $25.12	Facility	26	$11.75	$20.42	$25.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $281.84 / $549.54	Facility	TC	$48.98	$281.84	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $56.23 / $147.91	Professional		$23.44	$56.23	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $18.62 / $52.48	Professional	26	$7.94	$18.62	$52.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.38 / $102.33 / $263.03	Professional	50	$17.38	$102.33	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $44.67 / $91.20	Professional	TC	$25.70	$44.67	$91.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $186.21 / $309.03	Facility		$85.11	$186.21	$309.03
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 $50.12 / $50.12 / $158.49	Facility	TC	$50.12	$50.12	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $74.13 / $102.33	Professional		$63.10	$74.13	$102.33
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 $47.86 / $56.23 / $79.43	Professional	TC	$47.86	$56.23	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $275.42 / $501.19	Facility		$109.65	$275.42	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $57.54 / $74.13	Professional		$34.67	$57.54	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $19.05	Professional	26	$9.33	$14.13	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $42.66 / $56.23	Professional	TC	$23.99	$42.66	$56.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $158.49	Professional		$123.03	$123.03	$158.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	26	$60.26	$60.26	$60.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $63.10 / $97.72	Professional	TC	$63.10	$63.10	$97.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $81.28 / $346.74	Facility		$38.02	$81.28	$346.74
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $22.91 / $28.84	Facility	26	$13.18	$22.91	$28.84
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $63.10 / $257.04 / $426.58	Facility	TC	$63.10	$257.04	$426.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $69.18 / $117.49	Professional		$33.11	$69.18	$117.49
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $17.78 / $30.90	Professional	26	$8.71	$17.78	$30.90
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $16.98 / $54.95 / $144.54	Professional	50	$16.98	$54.95	$144.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $57.54 / $74.13	Professional	TC	$28.84	$57.54	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $30.90 / $33.11	Professional		$7.24	$30.90	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $239.88 / $316.23	Facility		$158.49	$239.88	$316.23
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 $56.23 / $81.28 / $97.72	Professional		$56.23	$81.28	$97.72
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 $43.65 / $61.66 / $74.13	Professional	TC	$43.65	$61.66	$74.13
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $39.81 / $97.72	Professional		$38.90	$39.81	$97.72
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $8.91 / $19.95	Professional	26	$8.91	$8.91	$19.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $34.67 / $64.57	Professional	TC	$30.20	$34.67	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $39.81 / $79.43	Professional		$35.48	$39.81	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.00 / $19.50	Professional	26	$9.77	$10.00	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.20 / $57.54	Professional	TC	$26.30	$30.20	$57.54