Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $346.74 / $398.11	Facility		$74.13	$346.74	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $81.28	Facility	26	$44.67	$44.67	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $91.20 / $218.78	Professional		$46.77	$91.20	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $47.86 / $134.90	Professional	26	$28.18	$47.86	$134.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $177.83 / $346.74	Professional	50	$95.50	$177.83	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $32.36 / $47.86	Professional	TC	$14.13	$32.36	$47.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $263.03 / $446.68	Facility		$104.71	$263.03	$446.68
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $109.65	Professional		$75.86	$89.13	$109.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $57.54 / $70.79	Professional	26	$48.98	$57.54	$70.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $31.62 / $38.90	Professional	TC	$26.92	$31.62	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $371.54 / $602.56	Facility		$147.91	$371.54	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $162.18	Professional		$54.95	$85.11	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $53.70 / $93.33	Professional	26	$35.48	$53.70	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $70.79	Professional	TC	$21.88	$32.36	$70.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $234.42 / $234.42	Professional		$162.18	$234.42	$234.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	26	$223.87	$223.87	$223.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $13.18 / $223.87	Professional	TC	$13.18	$13.18	$223.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $95.50 / $204.17	Facility		$45.71	$95.50	$204.17
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $169.82	Professional		$54.95	$93.33	$169.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $56.23 / $91.20	Professional	26	$33.88	$56.23	$91.20
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $83.18 / $177.83 / $346.74	Professional	50	$83.18	$177.83	$346.74
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $33.88 / $56.23	Professional	TC	$20.42	$33.88	$56.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $32.36 / $33.11	Professional		$13.18	$32.36	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $295.12 / $389.05	Facility		$213.80	$295.12	$389.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $97.72 / $162.18	Professional		$64.57	$97.72	$162.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $61.66 / $81.28	Professional	26	$40.74	$61.66	$81.28
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $75.86	Professional	TC	$23.99	$36.31	$75.86
Select Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $169.82	Professional		$45.71	$45.71	$169.82
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $29.51 / $66.07	Professional	26	$29.51	$29.51	$66.07
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $18.20 / $35.48	Professional	TC	$16.60	$18.20	$35.48
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $93.33 / $186.21	Professional		$53.70	$93.33	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $52.48 / $104.71	Professional	26	$32.36	$52.48	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $40.74 / $81.28	Professional	TC	$21.88	$40.74	$81.28