Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $123.03 / $154.88	Facility	26	$109.65	$123.03	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $257.04	Professional		$89.13	$125.89	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $50.12 / $104.71	Professional	26	$31.62	$50.12	$104.71
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility	26	$2,754.23	$2,754.23	$2,754.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $269.15	Professional		$165.96	$194.98	$269.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $125.89	Professional	26	$77.62	$91.20	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $239.88	Professional		$114.82	$169.82	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $66.07 / $93.33	Professional	26	$38.90	$66.07	$93.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $309.03	Professional		$281.84	$281.84	$309.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $144.54 / $223.87	Professional	26	$144.54	$144.54	$223.87
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $123.03 / $154.88	Facility	26	$109.65	$123.03	$154.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $204.17 / $257.04	Professional		$120.23	$204.17	$257.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $85.11 / $107.15	Professional	26	$38.90	$85.11	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility	26	$2,754.23	$2,754.23	$2,754.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $218.78 / $263.03	Professional		$169.82	$218.78	$263.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $97.72 / $123.03	Professional	26	$60.26	$97.72	$123.03
Select Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $102.33 / $263.03	Professional		$100.00	$102.33	$263.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $100.00	Professional	26	$45.71	$45.71	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $239.88	Professional		$109.65	$128.82	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $37.15 / $70.79	Professional	26	$34.67	$37.15	$70.79