Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $8,317.64 / $8,317.64	Facility		$363.08	$8,317.64	$8,317.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $204.17 / $208.93	Facility	26	$204.17	$204.17	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $363.08	Professional		$109.65	$181.97	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $81.28 / $173.78	Professional	26	$50.12	$81.28	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $117.49 / $234.42	Professional	TC	$57.54	$117.49	$234.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $6,165.95 / $9,549.93	Facility		$954.99	$6,165.95	$9,549.93
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $5,495.41 / $5,495.41 / $5,495.41	Facility	26	$5,495.41	$5,495.41	$5,495.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $269.15 / $380.19	Professional		$229.09	$269.15	$380.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $147.91 / $208.93	Professional	26	$125.89	$147.91	$208.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $120.23 / $169.82	Professional	TC	$102.33	$120.23	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $9,549.93 / $17,378.01	Facility		$3,890.45	$9,549.93	$17,378.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $363.08	Professional		$173.78	$245.47	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $117.49 / $169.82	Professional	26	$64.57	$117.49	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $120.23 / $234.42	Professional	TC	$83.18	$120.23	$234.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $851.14	Professional		$758.58	$758.58	$851.14
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $645.65 / $645.65	Professional	26	$331.13	$645.65	$645.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $524.81	Professional	TC	$123.03	$123.03	$524.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $302.00 / $724.44	Facility		$138.04	$302.00	$724.44
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $204.17 / $204.17	Facility	26	$204.17	$204.17	$204.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $281.84 / $416.87	Professional		$165.96	$281.84	$416.87
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $141.25 / $177.83	Professional	26	$57.54	$141.25	$177.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $134.90 / $257.04	Professional	TC	$79.43	$134.90	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,495.41 / $7,585.78 / $10,964.78	Facility		$5,495.41	$7,585.78	$10,964.78
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,495.41 / $5,495.41 / $5,495.41	Facility	26	$5,495.41	$5,495.41	$5,495.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $309.03 / $380.19	Professional		$245.47	$309.03	$380.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $162.18 / $199.53	Professional	26	$95.50	$162.18	$199.53
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $141.25 / $234.42	Professional	TC	$114.82	$141.25	$234.42
Select Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $467.74	Professional		$138.04	$138.04	$467.74
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $165.96	Professional	26	$75.86	$75.86	$165.96
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $91.20 / $5,128.61	Professional	TC	$63.10	$91.20	$5,128.61
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $208.93 / $407.38	Professional		$165.96	$208.93	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $89.13 / $147.91	Professional	26	$54.95	$89.13	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $134.90 / $288.40	Professional	TC	$79.43	$134.90	$288.40