Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $8.71 / $30.20	Facility		$8.71	$8.71	$30.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $20.42 / $20.42	Facility	26	$20.42	$20.42	$20.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $13.49 / $38.02	Professional		$10.72	$13.49	$38.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.32 / $15.85	Professional	26	$6.03	$8.32	$15.85
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $12.30 / $12.30 / $12.30	Professional	50	$12.30	$12.30	$12.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $3.98 / $7.41	Professional	TC	$2.00	$3.98	$7.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $58.88 / $102.33	Facility		$11.75	$58.88	$102.33
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	26	$47.86	$47.86	$47.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $20.89 / $25.70	Professional		$17.38	$20.89	$25.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.45 / $17.78	Professional	26	$12.30	$14.45	$17.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $5.37 / $6.31 / $7.94	Professional	TC	$5.37	$6.31	$7.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $83.18 / $162.18	Facility		$33.88	$83.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $17.78 / $30.90	Professional		$12.02	$17.78	$30.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.59 / $20.42	Professional	26	$8.13	$12.59	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.80 / $5.62 / $10.23	Professional	TC	$3.80	$5.62	$10.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $50.12 / $50.12	Professional		$33.88	$50.12	$50.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $48.98 / $48.98	Professional	26	$22.91	$48.98	$48.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.17 / $1.17 / $11.22	Professional	TC	$1.17	$1.17	$11.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $16.98 / $28.84	Facility		$10.00	$16.98	$28.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $20.42 / $27.54	Professional		$12.30	$20.42	$27.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $14.13 / $19.05	Professional	26	$8.32	$14.13	$19.05
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $12.30 / $12.30 / $12.30	Professional	50	$12.30	$12.30	$12.30
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.98 / $7.08 / $8.91	Professional	TC	$3.98	$7.08	$8.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.69 / $32.36 / $33.11	Professional		$2.69	$32.36	$33.11
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $70.79 / $102.33	Facility		$47.86	$70.79	$102.33
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	26	$47.86	$47.86	$47.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $22.91 / $28.84	Professional		$15.85	$22.91	$28.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.49 / $18.62	Professional	26	$10.72	$15.49	$18.62
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $5.13 / $7.41 / $10.47	Professional	TC	$5.13	$7.41	$10.47
Select Health Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $10.72 / $27.54	Professional		$10.72	$10.72	$27.54
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.24 / $16.98	Professional	26	$7.24	$7.24	$16.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.55 / $3.72 / $7.24	Professional	TC	$3.55	$3.72	$7.24
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $14.79 / $29.51	Professional		$12.30	$14.79	$29.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.55 / $19.05	Professional	26	$8.32	$9.55	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.98 / $5.13 / $10.23	Professional	TC	$3.98	$5.13	$10.23