Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $1,047.13	Professional		$346.74	$478.63	$1,047.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $269.15	Professional	26	$85.11	$131.83	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $354.81 / $794.33	Professional	TC	$257.04	$354.81	$794.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $616.60 / $870.96	Professional		$562.34	$616.60	$870.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $162.18 / $223.87	Professional	26	$138.04	$162.18	$223.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $457.09 / $645.65	Professional	TC	$426.58	$457.09	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $489.78 / $870.96	Professional		$295.12	$489.78	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $100.00 / $181.97	Professional	26	$70.79	$100.00	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $371.54 / $645.65	Professional	TC	$218.78	$371.54	$645.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,737.80	Professional		$1,548.82	$1,548.82	$1,737.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $467.74 / $562.34 / $562.34	Professional	26	$467.74	$562.34	$562.34
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $977.24 / $977.24 / $1,258.93	Professional	TC	$977.24	$977.24	$1,258.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $660.69 / $1,071.52	Professional		$478.63	$660.69	$1,071.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $162.18 / $234.42	Professional	26	$120.23	$162.18	$234.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $501.19 / $794.33	Professional	TC	$338.84	$501.19	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $870.96	Professional		$524.81	$707.95	$870.96
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $169.82 / $213.80	Professional	26	$138.04	$169.82	$213.80
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $537.03 / $707.95	Professional	TC	$371.54	$537.03	$707.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $1,096.48	Professional		$309.03	$309.03	$1,096.48
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $190.55	Professional	26	$79.43	$79.43	$190.55
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $234.42 / $549.54	Professional	TC	$234.42	$234.42	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $977.24	Professional		$331.13	$467.74	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $91.20 / $181.97	Professional	26	$75.86	$91.20	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $371.54 / $812.83	Professional	TC	$257.04	$371.54	$812.83