Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $229.09 / $275.42	Facility	26	$134.90	$229.09	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $512.86 / $1,174.90	Professional		$371.54	$512.86	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $125.89 / $295.12	Professional	26	$93.33	$125.89	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $380.19 / $707.95	Professional	TC	$269.15	$380.19	$707.95
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $707.95 / $977.24	Professional		$602.56	$707.95	$977.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $194.98 / $275.42	Professional	26	$165.96	$194.98	$275.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $512.86 / $707.95	Professional	TC	$426.58	$512.86	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $457.09 / $954.99	Professional		$316.23	$457.09	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $112.20 / $208.93	Professional	26	$87.10	$112.20	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $331.13 / $724.44	Professional	TC	$229.09	$331.13	$724.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,584.89	Professional		$1,445.44	$1,445.44	$1,584.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $831.76 / $831.76 / $831.76	Professional	26	$831.76	$831.76	$831.76
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $616.60 / $616.60	Professional	TC	$616.60	$616.60	$616.60
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $263.03 / $275.42	Facility	26	$147.91	$263.03	$275.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $724.44 / $1,023.29	Professional		$416.87	$724.44	$1,023.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $190.55 / $263.03	Professional	26	$97.72	$190.55	$263.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $524.81 / $741.31	Professional	TC	$323.59	$524.81	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $251.19	Professional		$32.36	$33.11	$251.19
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $794.33 / $954.99	Professional		$549.54	$794.33	$954.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $204.17 / $263.03	Professional	26	$169.82	$204.17	$263.03
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $588.84 / $724.44	Professional	TC	$407.38	$588.84	$724.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $363.08 / $1,202.26	Professional		$354.81	$363.08	$1,202.26
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $97.72 / $223.87	Professional	26	$97.72	$97.72	$223.87
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $288.40 / $912.01	Professional	TC	$257.04	$288.40	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $489.78 / $1,023.29	Professional		$346.74	$489.78	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $117.49 / $223.87	Professional	26	$89.13	$117.49	$223.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $389.05 / $794.33	Professional	TC	$257.04	$389.05	$794.33