Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $15.49 / $16.60	Facility	26	$8.32	$15.49	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.70 / $275.42 / $478.63	Facility	TC	$53.70	$275.42	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $43.65 / $109.65	Professional		$22.91	$43.65	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $10.00 / $25.70	Professional	26	$5.01	$10.00	$25.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $51.29	Professional	TC	$19.05	$32.36	$51.29
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 $36.31 / $36.31 / $158.49	Facility	TC	$36.31	$36.31	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $52.48 / $72.44	Professional		$44.67	$52.48	$72.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.02 / $16.60	Professional	26	$10.00	$12.02	$16.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $40.74 / $56.23	Professional	TC	$34.67	$40.74	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $57.54	Professional		$27.54	$41.69	$57.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.55 / $13.49	Professional	26	$6.61	$9.55	$13.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $45.71	Professional	TC	$19.95	$30.90	$45.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $107.15	Professional		$77.62	$77.62	$107.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $42.66 / $42.66	Professional	26	$42.66	$42.66	$42.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $66.07	Professional	TC	$35.48	$35.48	$66.07
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $15.85 / $16.60	Facility	26	$9.12	$15.85	$16.60
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $51.29 / $186.21 / $346.74	Facility	TC	$51.29	$186.21	$346.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $50.12 / $81.28	Professional		$29.51	$50.12	$81.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $12.02 / $17.78	Professional	26	$6.03	$12.02	$17.78
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $39.81 / $50.12	Professional	TC	$23.44	$39.81	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $22.39 / $33.11	Professional		$5.01	$22.39	$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 $41.69 / $57.54 / $69.18	Professional		$41.69	$57.54	$69.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.59 / $15.85	Professional	26	$10.47	$12.59	$15.85
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $44.67 / $53.70	Professional	TC	$31.62	$44.67	$53.70
Select Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $27.54 / $69.18	Professional		$26.30	$27.54	$69.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $6.03 / $13.80	Professional	26	$6.03	$6.03	$13.80
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $24.55 / $47.86	Professional	TC	$20.42	$24.55	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $30.90 / $57.54	Professional		$28.18	$30.90	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $6.92 / $13.49	Professional	26	$6.46	$6.92	$13.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $23.99 / $45.71	Professional	TC	$21.38	$23.99	$45.71