Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $501.19 / $1,348.96	Professional		$354.81	$501.19	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $141.25 / $371.54	Professional	26	$83.18	$141.25	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $363.08 / $831.76	Professional	TC	$257.04	$363.08	$831.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $616.60 / $870.96	Professional		$562.34	$616.60	$870.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $158.49 / $223.87	Professional	26	$134.90	$158.49	$223.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $467.74 / $645.65	Professional	TC	$426.58	$467.74	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $489.78 / $870.96	Professional		$295.12	$489.78	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $100.00 / $177.83	Professional	26	$70.79	$100.00	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $371.54 / $645.65	Professional	TC	$223.87	$371.54	$645.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,862.09	Professional		$1,659.59	$1,659.59	$1,862.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $537.03 / $575.44 / $575.44	Professional	26	$537.03	$575.44	$575.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,096.48 / $1,096.48 / $1,318.26	Professional	TC	$1,096.48	$1,096.48	$1,318.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $660.69 / $1,096.48	Professional		$478.63	$660.69	$1,096.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $162.18 / $229.09	Professional	26	$109.65	$162.18	$229.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $501.19 / $831.76	Professional	TC	$338.84	$501.19	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $707.95 / $851.14	Professional		$524.81	$707.95	$851.14
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $169.82 / $213.80	Professional	26	$138.04	$169.82	$213.80
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $549.54 / $691.83	Professional	TC	$371.54	$549.54	$691.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $1,096.48	Professional		$309.03	$309.03	$1,096.48
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 $234.42 / $234.42 / $562.34	Professional	TC	$234.42	$234.42	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $954.99	Professional		$331.13	$467.74	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $91.20 / $181.97	Professional	26	$74.13	$91.20	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $371.54 / $812.83	Professional	TC	$257.04	$371.54	$812.83