Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $234.42 / $295.12	Facility		$48.98	$234.42	$295.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $19.50 / $22.91	Facility	26	$11.48	$19.50	$22.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $275.42 / $346.74	Facility	TC	$48.98	$275.42	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $40.74 / $107.15	Professional		$23.99	$40.74	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $16.60 / $40.74	Professional	26	$7.94	$16.60	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.91 / $47.86	Professional	TC	$16.60	$22.91	$47.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $181.97 / $269.15	Facility		$81.28	$181.97	$269.15
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 $33.88 / $33.88 / $158.49	Facility	TC	$33.88	$33.88	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $75.86	Professional		$46.77	$54.95	$75.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.60 / $22.91	Professional	26	$13.80	$16.60	$22.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $38.02 / $53.70	Professional	TC	$32.36	$38.02	$53.70
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 $28.18 / $42.66 / $54.95	Professional		$28.18	$42.66	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.18 / $18.20	Professional	26	$9.12	$13.18	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $38.02	Professional	TC	$18.20	$28.84	$38.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $109.65	Professional		$75.86	$109.65	$109.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $58.88 / $58.88	Professional	26	$46.77	$58.88	$58.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $52.48 / $52.48	Professional	TC	$29.51	$52.48	$52.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $72.44 / $281.84	Facility		$30.20	$72.44	$281.84
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $21.88 / $22.91	Facility	26	$12.59	$21.88	$22.91
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $229.09 / $338.84	Facility	TC	$48.98	$229.09	$338.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $56.23 / $83.18	Professional		$26.92	$56.23	$83.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $16.60 / $34.67	Professional	26	$8.32	$16.60	$34.67
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $38.90 / $47.86	Professional	TC	$18.20	$38.90	$47.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $22.91 / $33.11	Professional		$6.92	$22.91	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $218.78 / $309.03	Facility		$154.88	$218.78	$309.03
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 $45.71 / $58.88 / $72.44	Professional		$45.71	$58.88	$72.44
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $17.38 / $21.88	Professional	26	$14.45	$17.38	$21.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $41.69 / $50.12	Professional	TC	$30.20	$41.69	$50.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $69.18	Professional		$27.54	$27.54	$69.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.32 / $19.05	Professional	26	$8.32	$8.32	$19.05
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $19.95 / $44.67	Professional	TC	$19.05	$19.95	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.90 / $56.23	Professional		$26.30	$30.90	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.55 / $17.78	Professional	26	$8.91	$9.55	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $20.42 / $38.02	Professional	TC	$17.38	$20.42	$38.02