Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $53.70 / $97.72	Facility	26	$47.86	$53.70	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $162.18 / $407.38	Professional		$79.43	$162.18	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $57.54 / $154.88	Professional	26	$33.11	$57.54	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $60.26 / $162.18	Professional	TC	$38.02	$60.26	$162.18
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 $134.90 / $158.49 / $194.98	Professional		$134.90	$158.49	$194.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $69.18 / $77.62	Professional	26	$58.88	$69.18	$77.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $89.13 / $107.15	Professional	TC	$75.86	$89.13	$107.15
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 $36.31 / $56.23 / $81.28	Professional	26	$36.31	$56.23	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $72.44 / $112.20	Professional	TC	$45.71	$72.44	$112.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $630.96 / $630.96	Professional		$251.19	$630.96	$630.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $281.84 / $281.84	Professional	26	$91.20	$281.84	$281.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $346.74 / $346.74	Professional	TC	$162.18	$346.74	$346.74
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $91.20 / $117.49	Facility	26	$47.86	$91.20	$117.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $165.96 / $218.78	Professional		$91.20	$165.96	$218.78
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $66.07 / $102.33	Professional	26	$37.15	$66.07	$102.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $91.20 / $112.20	Professional	TC	$54.95	$91.20	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $66.07	Professional		$28.84	$33.11	$66.07
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 $114.82 / $165.96 / $186.21	Professional		$114.82	$165.96	$186.21
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $77.62	Professional	26	$51.29	$74.13	$77.62
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $95.50 / $107.15	Professional	TC	$64.57	$95.50	$107.15
Select Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $81.28 / $177.83	Professional		$79.43	$81.28	$177.83
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $75.86	Professional	26	$35.48	$35.48	$75.86
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $47.86 / $95.50	Professional	TC	$46.77	$47.86	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $186.21	Professional		$89.13	$93.33	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $40.74 / $75.86	Professional	26	$38.02	$40.74	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $54.95 / $109.65	Professional	TC	$48.98	$54.95	$109.65