Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $123.03 / $239.88	Facility	26	$112.20	$123.03	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $741.31	Professional		$257.04	$371.54	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $95.50 / $239.88	Professional	26	$81.28	$95.50	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $416.87	Professional	TC	$169.82	$281.84	$416.87
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 $416.87 / $489.78 / $691.83	Professional		$416.87	$489.78	$691.83
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 $281.84 / $331.13 / $478.63	Professional	TC	$281.84	$331.13	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $758.58	Professional		$257.04	$371.54	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $177.83	Professional	26	$72.44	$104.71	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $257.04 / $588.84	Professional	TC	$181.97	$257.04	$588.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,380.38	Professional		$1,230.27	$1,230.27	$1,380.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $549.54 / $549.54 / $588.84	Professional	26	$549.54	$549.54	$588.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $691.83 / $794.33	Professional	TC	$691.83	$691.83	$794.33
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $229.09 / $288.40	Facility	26	$112.20	$229.09	$288.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $575.44 / $851.14	Professional		$316.23	$575.44	$851.14
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $165.96 / $234.42	Professional	26	$87.10	$165.96	$234.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $416.87 / $616.60	Professional	TC	$218.78	$416.87	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $177.83	Professional		$32.36	$33.11	$177.83
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 $446.68 / $645.65 / $758.58	Professional		$446.68	$645.65	$758.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $169.82 / $213.80	Professional	26	$141.25	$169.82	$213.80
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $467.74 / $575.44	Professional	TC	$323.59	$467.74	$575.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $251.19 / $831.76	Professional		$245.47	$251.19	$831.76
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 $165.96 / $229.09 / $478.63	Professional	TC	$165.96	$229.09	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $416.87 / $831.76	Professional		$281.84	$416.87	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $95.50 / $190.55	Professional	26	$79.43	$95.50	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $338.84 / $676.08	Professional	TC	$199.53	$338.84	$676.08