Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $154.88	Facility	26	$85.11	$85.11	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $457.09	Professional		$165.96	$213.80	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $60.26 / $125.89	Professional	26	$41.69	$60.26	$125.89
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 $331.13 / $389.05 / $549.54	Professional		$331.13	$389.05	$549.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $154.88	Professional	26	$95.50	$112.20	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $323.59 / $436.52	Professional		$204.17	$323.59	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $89.13 / $117.49	Professional	26	$53.70	$89.13	$117.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $467.74	Professional		$426.58	$426.58	$467.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $194.98 / $194.98	Professional	26	$162.18	$194.98	$194.98
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $151.36	Facility	26	$85.11	$85.11	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $398.11 / $478.63	Professional		$208.93	$398.11	$478.63
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $104.71 / $128.82	Professional	26	$52.48	$104.71	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $141.25	Professional		$32.36	$33.11	$141.25
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 $316.23 / $446.68 / $537.03	Professional		$316.23	$446.68	$537.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $147.91	Professional	26	$83.18	$117.49	$147.91
Select Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $199.53 / $537.03	Professional		$194.98	$199.53	$537.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $128.82	Professional	26	$54.95	$54.95	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $223.87 / $446.68	Professional		$208.93	$223.87	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $64.57 / $114.82	Professional	26	$47.86	$64.57	$114.82