Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $478.63 / $954.99	Professional		$309.03	$478.63	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $257.04	Professional	26	$81.28	$125.89	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $338.84 / $707.95	Professional	TC	$229.09	$338.84	$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 $512.86 / $562.34 / $776.25	Professional		$512.86	$562.34	$776.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $154.88 / $213.80	Professional	26	$131.83	$154.88	$213.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $407.38 / $562.34	Professional	TC	$380.19	$407.38	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $457.09 / $870.96	Professional		$263.03	$457.09	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $95.50 / $173.78	Professional	26	$69.18	$95.50	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $354.81 / $691.83	Professional	TC	$194.98	$354.81	$691.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,737.80	Professional		$1,584.89	$1,584.89	$1,737.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $616.60 / $616.60 / $676.08	Professional	26	$616.60	$616.60	$676.08
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $954.99 / $954.99 / $1,071.52	Professional	TC	$954.99	$954.99	$1,071.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $588.84 / $954.99	Professional		$478.63	$588.84	$954.99
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $158.49 / $223.87	Professional	26	$125.89	$158.49	$223.87
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $436.52 / $707.95	Professional	TC	$338.84	$436.52	$707.95
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 $467.74 / $645.65 / $954.99	Professional		$467.74	$645.65	$954.99
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $162.18 / $208.93	Professional	26	$131.83	$162.18	$208.93
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $489.78 / $794.33	Professional	TC	$331.13	$489.78	$794.33
Select Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $288.40 / $977.24	Professional		$281.84	$288.40	$977.24
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $181.97	Professional	26	$75.86	$75.86	$181.97
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $229.09 / $912.01	Professional	TC	$204.17	$229.09	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $501.19 / $1,071.52	Professional		$302.00	$501.19	$1,071.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $89.13 / $169.82	Professional	26	$72.44	$89.13	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $426.58 / $891.25	Professional	TC	$229.09	$426.58	$891.25