Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $47.86 / $85.11	Facility	26	$43.65	$47.86	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $269.15	Professional		$91.20	$117.49	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $83.18	Professional	26	$26.92	$33.88	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $81.28 / $173.78	Professional	TC	$61.66	$81.28	$173.78
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 $165.96 / $199.53 / $275.42	Professional		$165.96	$199.53	$275.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $63.10 / $87.10	Professional	26	$53.70	$63.10	$87.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $134.90 / $186.21	Professional	TC	$114.82	$134.90	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $213.80	Professional		$109.65	$162.18	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $50.12 / $67.61	Professional	26	$34.67	$50.12	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $109.65 / $144.54	Professional	TC	$72.44	$109.65	$144.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $562.34	Professional		$426.58	$426.58	$562.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	26	$223.87	$223.87	$223.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	TC	$208.93	$208.93	$208.93
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $47.86 / $104.71	Facility	26	$43.65	$47.86	$104.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $199.53 / $269.15	Professional		$107.15	$199.53	$269.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $60.26 / $81.28	Professional	26	$32.36	$60.26	$81.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $138.04 / $173.78	Professional	TC	$74.13	$138.04	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.11 / $70.79	Professional		$26.30	$33.11	$70.79
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 $181.97 / $223.87 / $269.15	Professional		$181.97	$223.87	$269.15
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $66.07 / $83.18	Professional	26	$53.70	$66.07	$83.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $158.49 / $186.21	Professional	TC	$123.03	$158.49	$186.21
Select Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $234.42	Professional		$97.72	$97.72	$234.42
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $72.44	Professional	26	$30.90	$30.90	$72.44
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $69.18 / $162.18	Professional	TC	$67.61	$69.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $208.93	Professional		$104.71	$114.82	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $36.31 / $69.18	Professional	26	$33.88	$36.31	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $77.62 / $141.25	Professional	TC	$70.79	$77.62	$141.25