Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $95.50 / $177.83	Facility	26	$85.11	$95.50	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $371.54 / $912.01	Professional		$239.88	$371.54	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $87.10 / $169.82	Professional	26	$61.66	$87.10	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $288.40 / $602.56	Professional	TC	$173.78	$288.40	$602.56
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 $389.05 / $457.09 / $630.96	Professional		$389.05	$457.09	$630.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $125.89 / $173.78	Professional	26	$107.15	$125.89	$173.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $457.09	Professional	TC	$281.84	$331.13	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $331.13 / $602.56	Professional		$218.78	$331.13	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $131.83	Professional	26	$54.95	$77.62	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $234.42 / $489.78	Professional	TC	$165.96	$234.42	$489.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,071.52 / $1,071.52	Professional		$691.83	$1,071.52	$1,071.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $524.81 / $524.81 / $524.81	Professional	26	$524.81	$524.81	$524.81
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $537.03 / $537.03	Professional	TC	$165.96	$537.03	$537.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $147.91 / $223.87	Facility	26	$85.11	$147.91	$223.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $489.78 / $724.44	Professional		$288.40	$489.78	$724.44
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $125.89 / $162.18	Professional	26	$67.61	$125.89	$162.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $371.54 / $549.54	Professional	TC	$213.80	$371.54	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $162.18	Professional		$32.36	$33.11	$162.18
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 $380.19 / $549.54 / $660.69	Professional		$380.19	$549.54	$660.69
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $131.83 / $169.82	Professional	26	$107.15	$131.83	$169.82
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $416.87 / $489.78	Professional	TC	$295.12	$416.87	$489.78
Select Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $229.09 / $676.08	Professional		$223.87	$229.09	$676.08
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $144.54	Professional	26	$61.66	$61.66	$144.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $199.53 / $457.09	Professional	TC	$165.96	$199.53	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $691.83	Professional		$239.88	$354.81	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $144.54	Professional	26	$57.54	$72.44	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $295.12 / $549.54	Professional	TC	$177.83	$295.12	$549.54