Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $467.74 / $467.74	Facility	26	$323.59	$467.74	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $602.56 / $1,380.38	Professional		$389.05	$602.56	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $229.09 / $416.87	Professional	26	$123.03	$229.09	$416.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $346.74 / $794.33	Professional	TC	$257.04	$346.74	$794.33
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 $616.60 / $676.08 / $933.25	Professional		$616.60	$676.08	$933.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $229.09 / $323.59	Professional	26	$194.98	$229.09	$323.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $436.52 / $616.60	Professional	TC	$416.87	$436.52	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $954.99	Professional		$323.59	$524.81	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $144.54 / $245.47	Professional	26	$102.33	$144.54	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $363.08 / $660.69	Professional	TC	$218.78	$363.08	$660.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,344.23 / $2,630.27	Professional		$2,344.23	$2,344.23	$2,630.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Professional	26	$1,000.00	$1,000.00	$1,000.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional	TC	$1,348.96	$1,348.96	$1,348.96
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Facility	26	$467.74	$467.74	$467.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $724.44 / $1,174.90	Professional		$478.63	$724.44	$1,174.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $239.88 / $338.84	Professional	26	$141.25	$239.88	$338.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $489.78 / $794.33	Professional	TC	$338.84	$489.78	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $239.88	Professional		$32.36	$33.11	$239.88
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 $588.84 / $776.25 / $912.01	Professional		$588.84	$776.25	$912.01
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $239.88 / $309.03	Professional	26	$199.53	$239.88	$309.03
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $524.81 / $660.69	Professional	TC	$371.54	$524.81	$660.69
Select Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $346.74 / $1,148.15	Professional		$338.84	$346.74	$1,148.15
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $114.82 / $269.15	Professional	26	$114.82	$114.82	$269.15
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $251.19 / $891.25	Professional	TC	$223.87	$251.19	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $512.86 / $1,000.00	Professional		$363.08	$512.86	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $138.04 / $257.04	Professional	26	$109.65	$138.04	$257.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $363.08 / $776.25	Professional	TC	$251.19	$363.08	$776.25