Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Facility	26	$25.12	$25.12	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $45.71 / $275.42	Professional		$21.88	$45.71	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.96 / $48.98	Professional	26	$8.91	$10.96	$48.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $26.92 / $186.21	Professional	TC	$12.88	$26.92	$186.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $46.77 / $66.07	Professional		$39.81	$46.77	$66.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $17.78 / $24.55	Professional	26	$15.14	$17.78	$24.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $28.84 / $40.74	Professional	TC	$24.55	$28.84	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $91.20	Professional		$25.12	$38.02	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.45 / $19.95	Professional	26	$9.77	$14.45	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $21.88 / $81.28	Professional	TC	$13.80	$21.88	$81.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $309.03	Professional		$213.80	$309.03	$309.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	26	$77.62	$77.62	$77.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	TC	$229.09	$229.09	$229.09
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Facility	26	$25.12	$25.12	$25.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $169.82	Professional		$30.20	$47.86	$169.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $18.62 / $28.18	Professional	26	$9.55	$18.62	$28.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $120.23	Professional	TC	$20.89	$30.20	$120.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $19.95 / $33.11	Professional		$7.41	$19.95	$33.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $109.65	Professional		$41.69	$50.12	$109.65
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $18.62 / $23.44	Professional	26	$15.49	$18.62	$23.44
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.20 / $91.20	Professional	TC	$25.70	$30.20	$91.20
Select Health Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $134.90	Professional		$23.44	$23.44	$134.90
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $8.91 / $19.50	Professional	26	$8.91	$8.91	$19.50
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $15.14 / $32.36	Professional	TC	$14.45	$15.14	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $39.81 / $125.89	Professional		$19.95	$39.81	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $20.42	Professional	26	$8.32	$10.72	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $22.91 / $104.71	Professional	TC	$11.22	$22.91	$104.71