Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $177.83 / $309.03	Facility	26	$89.13	$177.83	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $478.63 / $1,348.96	Professional		$204.17	$478.63	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $141.25 / $380.19	Professional	26	$69.18	$141.25	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $302.00 / $562.34	Professional	TC	$134.90	$302.00	$562.34
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $363.08 / $501.19	Professional		$346.74	$363.08	$501.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $128.82 / $181.97	Professional	26	$112.20	$128.82	$181.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $234.42 / $323.59	Professional	TC	$223.87	$234.42	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $338.84 / $616.60	Professional		$169.82	$338.84	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $81.28 / $169.82	Professional	26	$57.54	$81.28	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $208.93 / $501.19	Professional	TC	$112.20	$208.93	$501.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,513.56	Professional		$1,348.96	$1,348.96	$1,513.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $575.44 / $575.44	Professional	26	$426.58	$575.44	$575.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $794.33 / $1,071.52	Professional	TC	$794.33	$794.33	$1,071.52
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $251.19 / $331.13	Facility	26	$89.13	$251.19	$331.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $389.05 / $912.01	Professional		$316.23	$389.05	$912.01
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $131.83 / $194.98	Professional	26	$97.72	$131.83	$194.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $257.04 / $630.96	Professional	TC	$208.93	$257.04	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $426.58 / $691.83	Professional		$309.03	$426.58	$691.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $138.04 / $173.78	Professional	26	$112.20	$138.04	$173.78
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $281.84 / $562.34	Professional	TC	$190.55	$281.84	$562.34
Select Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $186.21 / $831.76	Professional		$181.97	$186.21	$831.76
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $158.49	Professional	26	$64.57	$64.57	$158.49
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $131.83 / $630.96	Professional	TC	$117.49	$131.83	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $363.08 / $776.25	Professional		$194.98	$363.08	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $75.86 / $141.25	Professional	26	$60.26	$75.86	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $263.03 / $616.60	Professional	TC	$131.83	$263.03	$616.60