Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $112.20 / $295.12	Facility	26	$100.00	$112.20	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $478.63 / $1,380.38	Professional		$323.59	$478.63	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $141.25 / $281.84	Professional	26	$77.62	$141.25	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $758.58	Professional	TC	$251.19	$338.84	$758.58
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	26	$1,380.38	$1,380.38	$1,380.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $575.44 / $812.83	Professional		$537.03	$575.44	$812.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $144.54 / $204.17	Professional	26	$123.03	$144.54	$204.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $436.52 / $602.56	Professional	TC	$407.38	$436.52	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $457.09 / $812.83	Professional		$275.42	$457.09	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $169.82	Professional	26	$64.57	$89.13	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $354.81 / $676.08	Professional	TC	$213.80	$354.81	$676.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $2,344.23	Professional		$1,737.80	$1,737.80	$2,344.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $630.96 / $630.96 / $630.96	Professional	26	$630.96	$630.96	$630.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,096.48 / $1,096.48 / $1,698.24	Professional	TC	$1,096.48	$1,096.48	$1,698.24
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $257.04 / $371.54	Facility	26	$100.00	$257.04	$371.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $616.60 / $1,122.02	Professional		$436.52	$616.60	$1,122.02
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $147.91 / $208.93	Professional	26	$109.65	$147.91	$208.93
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $478.63 / $776.25	Professional	TC	$338.84	$478.63	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $208.93	Professional		$32.36	$33.11	$208.93
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	26	$1,380.38	$1,380.38	$1,380.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $676.08 / $812.83	Professional		$489.78	$676.08	$812.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $154.88 / $194.98	Professional	26	$125.89	$154.88	$194.98
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $512.86 / $660.69	Professional	TC	$354.81	$512.86	$660.69
Select Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $302.00 / $1,000.00	Professional		$295.12	$302.00	$1,000.00
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $72.44 / $177.83	Professional	26	$72.44	$72.44	$177.83
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $245.47 / $1,513.56	Professional	TC	$218.78	$245.47	$1,513.56
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $446.68 / $912.01	Professional		$316.23	$446.68	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $83.18 / $158.49	Professional	26	$67.61	$83.18	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $363.08 / $758.58	Professional	TC	$245.47	$363.08	$758.58