Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $39.81 / $72.44	Facility	26	$36.31	$39.81	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $302.00	Professional		$72.44	$112.20	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $31.62 / $85.11	Professional	26	$24.55	$31.62	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $79.43 / $177.83	Professional	TC	$47.86	$79.43	$177.83
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $186.21 / $257.04	Professional		$144.54	$186.21	$257.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $72.44	Professional	26	$43.65	$52.48	$72.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $134.90 / $186.21	Professional	TC	$95.50	$134.90	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $269.15	Professional		$81.28	$112.20	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.20 / $77.62	Professional	26	$22.91	$30.20	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $79.43 / $194.98	Professional	TC	$58.88	$79.43	$194.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $245.47	Professional		$199.53	$199.53	$245.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Professional	26	$323.59	$323.59	$323.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $323.59 / $323.59	Professional	TC	$323.59	$323.59	$323.59
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $39.81 / $74.13	Facility	26	$36.31	$39.81	$74.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $173.78 / $245.47	Professional		$72.44	$173.78	$245.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $51.29 / $74.13	Professional	26	$28.18	$51.29	$74.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $138.04 / $165.96	Professional	TC	$64.57	$138.04	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $33.11 / $66.07	Professional		$21.88	$33.11	$66.07
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $263.03	Professional		$147.91	$208.93	$263.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $69.18	Professional	26	$44.67	$54.95	$69.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $154.88 / $190.55	Professional	TC	$102.33	$154.88	$190.55
Select Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $95.50 / $218.78	Professional		$93.33	$95.50	$218.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $60.26	Professional	26	$25.70	$25.70	$60.26
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $75.86 / $177.83	Professional	TC	$66.07	$75.86	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $107.15 / $223.87	Professional		$91.20	$107.15	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $58.88	Professional	26	$22.91	$30.90	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $81.28 / $162.18	Professional	TC	$66.07	$81.28	$162.18