Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $151.36 / $151.36	Facility	26	$72.44	$151.36	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $234.42 / $537.03	Professional		$141.25	$234.42	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $75.86 / $158.49	Professional	26	$53.70	$75.86	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $147.91 / $338.84	Professional	TC	$81.28	$147.91	$338.84
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $257.04 / $354.81	Professional		$218.78	$257.04	$354.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $107.15 / $147.91	Professional	26	$91.20	$107.15	$147.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $147.91 / $208.93	Professional	TC	$125.89	$147.91	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $186.21 / $380.19	Professional		$114.82	$186.21	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $66.07 / $120.23	Professional	26	$46.77	$66.07	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $107.15 / $251.19	Professional	TC	$67.61	$107.15	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $794.33	Professional		$724.44	$724.44	$794.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $446.68 / $457.09 / $457.09	Professional	26	$446.68	$457.09	$457.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $269.15 / $346.74	Professional	TC	$269.15	$269.15	$346.74
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $151.36 / $151.36	Facility	26	$72.44	$151.36	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $269.15 / $416.87	Professional		$173.78	$269.15	$416.87
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $104.71 / $144.54	Professional	26	$57.54	$104.71	$144.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $162.18 / $281.84	Professional	TC	$120.23	$162.18	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $346.74	Professional		$213.80	$295.12	$346.74
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $112.20 / $144.54	Professional	26	$91.20	$112.20	$144.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $177.83 / $218.78	Professional	TC	$117.49	$177.83	$218.78
Select Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $128.82 / $363.08	Professional		$125.89	$128.82	$363.08
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $123.03	Professional	26	$52.48	$52.48	$123.03
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $85.11 / $275.42	Professional	TC	$74.13	$85.11	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $199.53 / $398.11	Professional		$128.82	$199.53	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $123.03	Professional	26	$48.98	$61.66	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $144.54 / $263.03	Professional	TC	$77.62	$144.54	$263.03