Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $234.42 / $239.88	Facility	26	$128.82	$234.42	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $371.54 / $707.95	Professional		$251.19	$371.54	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $107.15 / $288.40	Professional	26	$83.18	$107.15	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $537.03	Professional	TC	$169.82	$281.84	$537.03
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $707.95	Professional		$426.58	$501.19	$707.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $169.82 / $234.42	Professional	26	$144.54	$169.82	$234.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $478.63	Professional	TC	$281.84	$331.13	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $416.87 / $758.58	Professional		$275.42	$416.87	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $104.71 / $177.83	Professional	26	$74.13	$104.71	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $288.40 / $588.84	Professional	TC	$199.53	$288.40	$588.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,258.93	Professional		$1,148.15	$1,148.15	$1,258.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $398.11 / $398.11 / $398.11	Professional	26	$398.11	$398.11	$398.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $741.31 / $870.96	Professional	TC	$741.31	$741.31	$870.96
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $234.42 / $239.88	Facility	26	$128.82	$234.42	$239.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $616.60 / $891.25	Professional		$323.59	$616.60	$891.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $173.78 / $229.09	Professional	26	$91.20	$173.78	$229.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $446.68 / $660.69	Professional	TC	$218.78	$446.68	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $177.83	Professional		$32.36	$33.11	$177.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $676.08 / $812.83	Professional		$467.74	$676.08	$812.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $177.83 / $223.87	Professional	26	$144.54	$177.83	$223.87
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $501.19 / $588.84	Professional	TC	$346.74	$501.19	$588.84
Select Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $251.19 / $831.76	Professional		$245.47	$251.19	$831.76
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $83.18 / $194.98	Professional	26	$83.18	$83.18	$194.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $245.47 / $512.86	Professional	TC	$165.96	$245.47	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $416.87 / $831.76	Professional		$309.03	$416.87	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $95.50 / $194.98	Professional	26	$79.43	$95.50	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $316.23 / $645.65	Professional	TC	$223.87	$316.23	$645.65