Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	26	$134.90	$134.90	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $478.63	Professional		$173.78	$223.87	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $52.48 / $117.49	Professional	26	$41.69	$52.48	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $165.96 / $316.23	Professional	TC	$128.82	$165.96	$316.23
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $512.86	Professional		$316.23	$371.54	$512.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $97.72 / $138.04	Professional	26	$83.18	$97.72	$138.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $269.15 / $380.19	Professional	TC	$229.09	$269.15	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $575.44	Professional		$177.83	$251.19	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $57.54 / $104.71	Professional	26	$43.65	$57.54	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $181.97 / $316.23	Professional	TC	$134.90	$181.97	$316.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,122.02	Professional		$1,000.00	$1,000.00	$1,122.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $380.19 / $380.19	Professional	26	$380.19	$380.19	$380.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $630.96 / $630.96	Professional	TC	$630.96	$630.96	$630.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $389.05 / $549.54	Professional		$213.80	$389.05	$549.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $95.50 / $112.20	Professional	26	$50.12	$95.50	$112.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $281.84 / $354.81	Professional	TC	$165.96	$281.84	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $426.58 / $537.03	Professional		$316.23	$426.58	$537.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $104.71 / $131.83	Professional	26	$85.11	$104.71	$131.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $316.23 / $407.38	Professional	TC	$223.87	$316.23	$407.38
Select Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $407.38	Professional		$181.97	$181.97	$407.38
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $47.86 / $109.65	Professional	26	$47.86	$47.86	$109.65
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $138.04 / $478.63	Professional	TC	$134.90	$138.04	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $446.68	Professional		$190.55	$234.42	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $57.54 / $107.15	Professional	26	$45.71	$57.54	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $177.83 / $338.84	Professional	TC	$147.91	$177.83	$338.84