Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $128.82	Facility	26	$123.03	$123.03	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $354.81	Professional		$109.65	$158.49	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $60.26 / $109.65	Professional	26	$30.90	$60.26	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $104.71 / $245.47	Professional	TC	$79.43	$104.71	$245.47
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 $234.42 / $275.42 / $389.05	Professional		$234.42	$275.42	$389.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $128.82	Professional	26	$77.62	$91.20	$128.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $186.21 / $257.04	Professional	TC	$154.88	$186.21	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $309.03	Professional		$144.54	$223.87	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $64.57 / $97.72	Professional	26	$37.15	$64.57	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $154.88 / $239.88	Professional	TC	$104.71	$154.88	$239.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $389.05	Professional		$354.81	$354.81	$389.05
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	26	$218.78	$218.78	$218.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $134.90 / $173.78	Professional	TC	$134.90	$134.90	$173.78
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	26	$123.03	$123.03	$123.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $281.84 / $363.08	Professional		$138.04	$281.84	$363.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $83.18 / $107.15	Professional	26	$43.65	$83.18	$107.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $190.55 / $223.87	Professional	TC	$100.00	$190.55	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $100.00	Professional		$32.36	$33.11	$100.00
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 $218.78 / $309.03 / $380.19	Professional		$218.78	$309.03	$380.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $97.72 / $123.03	Professional	26	$60.26	$97.72	$123.03
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $218.78 / $251.19	Professional	TC	$154.88	$218.78	$251.19
Select Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $141.25 / $380.19	Professional		$138.04	$141.25	$380.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $107.15	Professional	26	$45.71	$45.71	$107.15
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $112.20 / $218.78	Professional	TC	$93.33	$112.20	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $158.49 / $316.23	Professional		$147.91	$158.49	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $52.48 / $91.20	Professional	26	$33.88	$52.48	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $125.89 / $234.42	Professional	TC	$104.71	$125.89	$234.42