Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $275.42 / $380.19	Facility		$56.23	$275.42	$380.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $16.98 / $20.42	Facility	26	$10.00	$16.98	$20.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.70 / $281.84 / $588.84	Facility	TC	$53.70	$281.84	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $38.90 / $95.50	Professional		$17.78	$38.90	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $15.49 / $42.66	Professional	26	$7.08	$15.49	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $77.62 / $257.04	Professional	50	$77.62	$77.62	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $31.62 / $53.70	Professional	TC	$19.05	$31.62	$53.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $186.21 / $269.15	Facility		$85.11	$186.21	$269.15
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 $48.98 / $57.54 / $79.43	Professional		$48.98	$57.54	$79.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.45 / $20.42	Professional	26	$12.30	$14.45	$20.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $42.66 / $60.26	Professional	TC	$36.31	$42.66	$60.26
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 $28.18 / $44.67 / $58.88	Professional		$28.18	$44.67	$58.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.75 / $16.60	Professional	26	$8.32	$11.75	$16.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $32.36 / $42.66	Professional	TC	$17.78	$32.36	$42.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $128.82	Professional		$97.72	$97.72	$128.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $53.70 / $53.70	Professional	26	$40.74	$53.70	$53.70
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $87.10	Professional	TC	$44.67	$44.67	$87.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $57.54 / $331.13	Facility		$28.84	$57.54	$331.13
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $19.50 / $20.42	Facility	26	$11.22	$19.50	$20.42
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $53.70 / $275.42 / $575.44	Facility	TC	$53.70	$275.42	$575.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $53.70 / $81.28	Professional		$23.99	$53.70	$81.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $14.79 / $22.91	Professional	26	$7.59	$14.79	$22.91
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $77.62 / $257.04	Professional	50	$77.62	$77.62	$257.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $39.81 / $53.70	Professional	TC	$19.95	$39.81	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $24.55 / $33.11	Professional		$6.17	$24.55	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $218.78 / $309.03	Facility		$147.91	$218.78	$309.03
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 $44.67 / $63.10 / $75.86	Professional		$44.67	$63.10	$75.86
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.49 / $19.05	Professional	26	$12.59	$15.49	$19.05
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $46.77 / $56.23	Professional	TC	$33.11	$46.77	$56.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $29.51 / $120.23	Professional		$28.84	$29.51	$120.23
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.41 / $16.98	Professional	26	$7.41	$7.41	$16.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $26.30 / $48.98	Professional	TC	$21.88	$26.30	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $30.90 / $58.88	Professional		$28.18	$30.90	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.71 / $16.60	Professional	26	$8.32	$8.71	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $22.91 / $42.66	Professional	TC	$19.95	$22.91	$42.66