Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $23.99 / $29.51	Facility	26	$14.13	$23.99	$29.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $52.48 / $346.74 / $467.74	Facility	TC	$52.48	$346.74	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $60.26 / $165.96	Professional		$33.88	$60.26	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $20.42 / $57.54	Professional	26	$10.00	$20.42	$57.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $123.03 / $346.74	Professional	50	$38.90	$123.03	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $53.70 / $83.18	Professional	TC	$28.84	$53.70	$83.18
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 $57.54 / $57.54 / $213.80	Facility	TC	$57.54	$57.54	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $120.23	Professional		$72.44	$85.11	$120.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $20.89 / $28.84	Professional	26	$17.78	$20.89	$28.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $64.57 / $91.20	Professional	TC	$54.95	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $85.11	Professional		$39.81	$66.07	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.60 / $22.91	Professional	26	$11.22	$16.60	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $47.86 / $63.10	Professional	TC	$27.54	$47.86	$63.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $177.83	Professional		$141.25	$141.25	$177.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $72.44 / $72.44	Professional	26	$58.88	$72.44	$72.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $70.79 / $120.23	Professional	TC	$70.79	$70.79	$120.23
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $26.30 / $28.84	Facility	26	$15.49	$26.30	$28.84
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $54.95 / $316.23 / $467.74	Facility	TC	$54.95	$316.23	$467.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $81.28 / $125.89	Professional		$38.90	$81.28	$125.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $20.89 / $30.90	Professional	26	$10.47	$20.89	$30.90
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $123.03 / $416.87	Professional	50	$38.90	$123.03	$416.87
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $67.61 / $91.20	Professional	TC	$32.36	$67.61	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $32.36 / $33.11	Professional		$8.71	$32.36	$33.11
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 $63.10 / $91.20 / $112.20	Professional		$63.10	$91.20	$112.20
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 $48.98 / $69.18 / $83.18	Professional	TC	$48.98	$69.18	$83.18
Select Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $46.77 / $112.20	Professional		$45.71	$46.77	$112.20
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.47 / $24.55	Professional	26	$10.47	$10.47	$24.55
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $39.81 / $75.86	Professional	TC	$35.48	$39.81	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $44.67 / $89.13	Professional		$39.81	$44.67	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.02 / $22.91	Professional	26	$11.48	$12.02	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $33.11 / $64.57	Professional	TC	$29.51	$33.11	$64.57