Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $95.50 / $112.20	Facility	26	$61.66	$95.50	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $331.13	Professional		$109.65	$147.91	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $46.77 / $102.33	Professional	26	$30.90	$46.77	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $97.72 / $229.09	Professional	TC	$75.86	$97.72	$229.09
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 $213.80 / $251.19 / $346.74	Professional		$213.80	$251.19	$346.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $112.20	Professional	26	$67.61	$79.43	$112.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $169.82 / $234.42	Professional	TC	$144.54	$169.82	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $204.17 / $269.15	Professional		$123.03	$204.17	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $63.10 / $83.18	Professional	26	$37.15	$63.10	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $141.25 / $190.55	Professional	TC	$85.11	$141.25	$190.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $426.58	Professional		$354.81	$354.81	$426.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $186.21 / $186.21	Professional	26	$123.03	$186.21	$186.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $169.82 / $309.03	Professional	TC	$169.82	$169.82	$309.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $95.50 / $107.15	Facility	26	$61.66	$95.50	$107.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $338.84	Professional		$131.83	$257.04	$338.84
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $74.13 / $93.33	Professional	26	$34.67	$74.13	$93.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $162.18 / $204.17	Professional	TC	$83.18	$162.18	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $89.13	Professional		$32.36	$33.11	$89.13
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 $199.53 / $281.84 / $338.84	Professional		$199.53	$281.84	$338.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $83.18 / $107.15	Professional	26	$57.54	$83.18	$107.15
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $199.53 / $234.42	Professional	TC	$141.25	$199.53	$234.42
Select Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $128.82 / $338.84	Professional		$125.89	$128.82	$338.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $39.81 / $93.33	Professional	26	$39.81	$39.81	$93.33
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $102.33 / $204.17	Professional	TC	$85.11	$102.33	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $141.25 / $269.15	Professional		$125.89	$141.25	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $45.71 / $81.28	Professional	26	$33.88	$45.71	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $97.72 / $190.55	Professional	TC	$91.20	$97.72	$190.55