Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $234.42	Professional		$72.44	$109.65	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.20 / $43.65	Professional	26	$14.13	$18.20	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $91.20 / $190.55	Professional	TC	$60.26	$91.20	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $275.42	Professional		$169.82	$199.53	$275.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $35.48 / $48.98	Professional	26	$30.20	$35.48	$48.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $162.18 / $229.09	Professional	TC	$138.04	$162.18	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $162.18 / $213.80	Professional		$85.11	$162.18	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $28.84 / $38.02	Professional	26	$18.62	$28.84	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $128.82 / $177.83	Professional	TC	$58.88	$128.82	$177.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $234.42	Professional		$208.93	$208.93	$234.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $60.26 / $60.26	Professional	26	$48.98	$60.26	$60.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $147.91 / $181.97	Professional	TC	$147.91	$147.91	$181.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $213.80 / $263.03	Professional		$109.65	$213.80	$263.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $37.15 / $41.69	Professional	26	$19.05	$37.15	$41.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $181.97 / $208.93	Professional	TC	$85.11	$181.97	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $33.11 / $70.79	Professional		$14.79	$33.11	$70.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $229.09 / $281.84	Professional		$138.04	$229.09	$281.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $38.02 / $46.77	Professional	26	$31.62	$38.02	$46.77
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $190.55 / $234.42	Professional	TC	$104.71	$190.55	$234.42
Select Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $107.15 / $239.88	Professional		$104.71	$107.15	$239.88
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.20 / $38.90	Professional	26	$18.20	$18.20	$38.90
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $102.33 / $234.42	Professional	TC	$87.10	$102.33	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $194.98	Professional		$77.62	$109.65	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $19.50 / $38.90	Professional	26	$18.62	$19.50	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $154.88	Professional	TC	$58.88	$91.20	$154.88