Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	26	$295.12	$295.12	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $269.15 / $512.86	Professional		$204.17	$269.15	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $120.23 / $251.19	Professional	26	$89.13	$120.23	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $131.83 / $281.84	Professional	TC	$97.72	$131.83	$281.84
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $416.87 / $602.56	Professional		$346.74	$416.87	$602.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $213.80 / $302.00	Professional	26	$181.97	$213.80	$302.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $199.53 / $288.40	Professional	TC	$165.96	$199.53	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $1,000.00	Professional		$363.08	$436.52	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $120.23 / $223.87	Professional	26	$95.50	$120.23	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $309.03 / $676.08	Professional	TC	$269.15	$309.03	$676.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,202.26	Professional		$1,071.52	$1,071.52	$1,202.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Professional	26	$426.58	$426.58	$426.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $645.65 / $645.65	Professional	TC	$645.65	$645.65	$645.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $776.25 / $954.99	Professional		$269.15	$776.25	$954.99
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $208.93 / $251.19	Professional	26	$114.82	$208.93	$251.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $562.34 / $707.95	Professional	TC	$131.83	$562.34	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $147.91	Professional		$32.36	$33.11	$147.91
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $891.25 / $1,047.13	Professional		$630.96	$891.25	$1,047.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $223.87 / $281.84	Professional	26	$181.97	$223.87	$281.84
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $645.65 / $776.25	Professional	TC	$457.09	$645.65	$776.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $912.01	Professional		$204.17	$204.17	$912.01
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $245.47	Professional	26	$107.15	$107.15	$245.47
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $173.78 / $660.69	Professional	TC	$97.72	$173.78	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $489.78 / $1,023.29	Professional		$416.87	$489.78	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $123.03 / $245.47	Professional	26	$97.72	$123.03	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $363.08 / $794.33	Professional	TC	$309.03	$363.08	$794.33