Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $223.87 / $269.15	Facility	26	$112.20	$223.87	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $398.11 / $1,071.52	Professional		$302.00	$398.11	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $128.82 / $371.54	Professional	26	$79.43	$128.82	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $275.42 / $524.81	Professional	TC	$218.78	$275.42	$524.81
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 $478.63 / $562.34 / $776.25	Professional		$478.63	$562.34	$776.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $162.18 / $229.09	Professional	26	$138.04	$162.18	$229.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $398.11 / $549.54	Professional	TC	$338.84	$398.11	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $645.65	Professional		$257.04	$371.54	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $100.00 / $169.82	Professional	26	$72.44	$100.00	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $263.03 / $426.58	Professional	TC	$186.21	$263.03	$426.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,862.09	Professional		$1,174.90	$1,174.90	$1,862.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $691.83 / $691.83 / $691.83	Professional	26	$691.83	$691.83	$691.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $478.63 / $1,174.90	Professional	TC	$478.63	$478.63	$1,174.90
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $229.09 / $269.15	Facility	26	$125.89	$229.09	$269.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $575.44 / $831.76	Professional		$338.84	$575.44	$831.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $151.36 / $251.19	Professional	26	$81.28	$151.36	$251.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $407.38 / $562.34	Professional	TC	$245.47	$407.38	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $199.53	Professional		$32.36	$33.11	$199.53
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 $446.68 / $630.96 / $758.58	Professional		$446.68	$630.96	$758.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $173.78 / $218.78	Professional	26	$141.25	$173.78	$218.78
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $467.74 / $549.54	Professional	TC	$323.59	$467.74	$549.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $288.40 / $776.25	Professional		$281.84	$288.40	$776.25
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $186.21	Professional	26	$79.43	$79.43	$186.21
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $223.87 / $758.58	Professional	TC	$199.53	$223.87	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $346.74 / $691.83	Professional		$281.84	$346.74	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $97.72 / $186.21	Professional	26	$74.13	$97.72	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $251.19 / $501.19	Professional	TC	$204.17	$251.19	$501.19