Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Facility	26	$63.10	$63.10	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $275.42	Professional		$112.20	$165.96	$275.42
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $338.84	Professional		$204.17	$239.88	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $169.82 / $251.19	Professional		$69.18	$169.82	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $363.08	Professional		$331.13	$331.13	$363.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $100.00 / $100.00	Professional	26	$83.18	$100.00	$100.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $257.04 / $331.13	Professional		$144.54	$257.04	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $32.36 / $70.79	Professional		$16.22	$32.36	$70.79
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	26	$707.95	$707.95	$707.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $275.42 / $331.13	Professional		$114.82	$275.42	$331.13
Select Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $758.58	Professional		$123.03	$123.03	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $131.83 / $371.54	Professional		$74.13	$131.83	$371.54