Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $281.84 / $446.68	Facility		$74.13	$281.84	$446.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $20.42 / $23.99	Facility	26	$10.96	$20.42	$23.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $66.07 / $281.84 / $549.54	Facility	TC	$66.07	$281.84	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $47.86 / $120.23	Professional		$17.78	$47.86	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $16.22 / $48.98	Professional	26	$7.59	$16.22	$48.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $112.20 / $128.82	Professional	50	$91.20	$112.20	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $44.67 / $81.28	Professional	TC	$22.91	$44.67	$81.28
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 $43.65 / $43.65 / $158.49	Facility	TC	$43.65	$43.65	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $91.20	Professional		$56.23	$66.07	$91.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.85 / $21.88	Professional	26	$13.49	$15.85	$21.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $50.12 / $69.18	Professional	TC	$42.66	$50.12	$69.18
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 $30.90 / $51.29 / $67.61	Professional		$30.90	$51.29	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $17.78	Professional	26	$8.71	$12.88	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.90 / $51.29	Professional	TC	$21.88	$38.90	$51.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $169.82	Professional		$109.65	$109.65	$169.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	26	$58.88	$58.88	$58.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $51.29 / $112.20	Professional	TC	$51.29	$51.29	$112.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $75.86 / $323.59	Facility		$33.88	$75.86	$323.59
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $21.38 / $23.99	Facility	26	$12.30	$21.38	$23.99
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $61.66 / $263.03 / $478.63	Facility	TC	$61.66	$263.03	$478.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $61.66 / $104.71	Professional		$25.12	$61.66	$104.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.85 / $28.18	Professional	26	$7.94	$15.85	$28.18
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $112.20 / $112.20	Professional	50	$91.20	$112.20	$112.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $50.12 / $70.79	Professional	TC	$25.70	$50.12	$70.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $27.54 / $33.11	Professional		$6.61	$27.54	$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 $51.29 / $72.44 / $89.13	Professional		$51.29	$72.44	$89.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.60 / $20.89	Professional	26	$13.80	$16.60	$20.89
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $56.23 / $67.61	Professional	TC	$38.90	$56.23	$67.61
Select Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $35.48 / $97.72	Professional		$33.88	$35.48	$97.72
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $18.20	Professional	26	$7.94	$7.94	$18.20
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.90 / $58.88	Professional	TC	$26.30	$30.90	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $35.48 / $70.79	Professional		$32.36	$35.48	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.12 / $17.78	Professional	26	$8.51	$9.12	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $26.30 / $52.48	Professional	TC	$23.44	$26.30	$52.48