Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $120.23 / $125.89	Facility	26	$67.61	$120.23	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $234.42 / $575.44	Professional		$125.89	$234.42	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $75.86 / $181.97	Professional	26	$43.65	$75.86	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $109.65 / $263.03	Professional	TC	$72.44	$109.65	$263.03
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 $208.93 / $245.47 / $309.03	Professional		$208.93	$245.47	$309.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $89.13 / $102.33	Professional	26	$75.86	$89.13	$102.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $154.88 / $186.21	Professional	TC	$131.83	$154.88	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $204.17 / $363.08	Professional		$128.82	$204.17	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $74.13 / $104.71	Professional	26	$46.77	$74.13	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $134.90 / $204.17	Professional	TC	$85.11	$134.90	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $512.86	Professional		$389.05	$389.05	$512.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $229.09 / $229.09	Professional	26	$186.21	$229.09	$229.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $323.59	Professional	TC	$162.18	$162.18	$323.59
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $114.82 / $125.89	Facility	26	$67.61	$114.82	$125.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $251.19 / $354.81	Professional		$144.54	$251.19	$354.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $85.11 / $123.03	Professional	26	$47.86	$85.11	$123.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $165.96 / $251.19	Professional	TC	$100.00	$165.96	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
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 $186.21 / $269.15 / $288.40	Professional		$186.21	$269.15	$288.40
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $93.33 / $102.33	Professional	26	$64.57	$93.33	$102.33
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $173.78 / $186.21	Professional	TC	$123.03	$173.78	$186.21
Select Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $288.40	Professional		$125.89	$125.89	$288.40
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $97.72	Professional	26	$44.67	$44.67	$97.72
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $89.13 / $173.78	Professional	TC	$81.28	$89.13	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $151.36 / $302.00	Professional		$141.25	$151.36	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $51.29 / $95.50	Professional	26	$47.86	$51.29	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $104.71 / $208.93	Professional	TC	$91.20	$104.71	$208.93