Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $281.84 / $562.34	Facility		$173.78	$281.84	$562.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $69.18 / $102.33	Facility	26	$42.66	$69.18	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $426.58	Professional		$67.61	$97.72	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $50.12 / $181.97	Professional	26	$30.20	$50.12	$181.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $104.71 / $446.68 / $1,122.02	Professional	50	$104.71	$446.68	$1,122.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $58.88 / $147.91	Professional	TC	$42.66	$58.88	$147.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $239.88 / $323.59	Facility		$138.04	$239.88	$323.59
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $194.98	Professional		$131.83	$154.88	$194.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $61.66 / $69.18	Professional	26	$52.48	$61.66	$69.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $93.33 / $112.20	Professional	TC	$79.43	$93.33	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $275.42 / $501.19	Facility		$109.65	$275.42	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $128.82 / $223.87	Professional		$81.28	$128.82	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $50.12 / $70.79	Professional	26	$31.62	$50.12	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $81.28 / $120.23	Professional	TC	$51.29	$81.28	$120.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $316.23 / $316.23	Professional		$181.97	$316.23	$316.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	26	$154.88	$154.88	$154.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $162.18 / $162.18	Professional	TC	$26.92	$162.18	$162.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $173.78 / $363.08	Facility		$75.86	$173.78	$363.08
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $81.28 / $102.33	Facility	26	$46.77	$81.28	$102.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $151.36 / $234.42	Professional		$79.43	$151.36	$234.42
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $57.54 / $85.11	Professional	26	$31.62	$57.54	$85.11
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $302.00 / $831.76	Professional	50	$100.00	$302.00	$831.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $93.33 / $114.82	Professional	TC	$54.95	$93.33	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $66.07	Professional		$25.70	$33.11	$66.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $229.09 / $316.23	Facility		$158.49	$229.09	$316.23
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $181.97	Professional		$117.49	$169.82	$181.97
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $64.57 / $69.18	Professional	26	$44.67	$64.57	$69.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $102.33 / $112.20	Professional	TC	$72.44	$102.33	$112.20
Select Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $204.17	Professional		$77.62	$77.62	$204.17
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $64.57	Professional	26	$30.20	$30.20	$64.57
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $48.98 / $95.50	Professional	TC	$47.86	$48.98	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $93.33 / $169.82	Professional		$85.11	$93.33	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $36.31 / $66.07	Professional	26	$33.11	$36.31	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $57.54 / $104.71	Professional	TC	$52.48	$57.54	$104.71