Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $102.33 / $109.65	Facility	26	$58.88	$102.33	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $194.98 / $501.19	Professional		$102.33	$194.98	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $67.61 / $213.80	Professional	26	$37.15	$67.61	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $83.18 / $234.42	Professional	TC	$56.23	$83.18	$234.42
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 $169.82 / $199.53 / $251.19	Professional		$169.82	$199.53	$251.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $91.20	Professional	26	$64.57	$75.86	$91.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $123.03 / $147.91	Professional	TC	$104.71	$123.03	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $288.40	Professional		$104.71	$165.96	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $63.10 / $91.20	Professional	26	$39.81	$63.10	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $104.71 / $158.49	Professional	TC	$63.10	$104.71	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $316.23	Professional		$257.04	$316.23	$316.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $213.80 / $213.80	Professional	26	$158.49	$213.80	$213.80
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	TC	$97.72	$97.72	$97.72
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $100.00 / $128.82	Facility	26	$58.88	$100.00	$128.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $199.53 / $309.03	Professional		$112.20	$199.53	$309.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $74.13 / $114.82	Professional	26	$41.69	$74.13	$114.82
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $123.03 / $154.88	Professional	TC	$67.61	$123.03	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
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 $151.36 / $218.78 / $234.42	Professional		$151.36	$218.78	$234.42
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $87.10	Professional	26	$56.23	$81.28	$87.10
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $138.04 / $147.91	Professional	TC	$95.50	$138.04	$147.91
Select Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $234.42	Professional		$104.71	$104.71	$234.42
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $83.18	Professional	26	$38.90	$38.90	$83.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $69.18 / $128.82	Professional	TC	$64.57	$69.18	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $123.03 / $245.47	Professional		$114.82	$123.03	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $44.67 / $85.11	Professional	26	$42.66	$44.67	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $79.43 / $158.49	Professional	TC	$72.44	$79.43	$158.49