Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $64.57	Facility	26	$34.67	$34.67	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $83.18 / $251.19	Professional		$39.81	$83.18	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $38.90 / $100.00	Professional	26	$20.89	$38.90	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $24.55 / $95.50	Professional	TC	$16.98	$24.55	$95.50
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 $69.18 / $81.28 / $102.33	Professional		$69.18	$81.28	$102.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $44.67 / $52.48	Professional	26	$38.02	$44.67	$52.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $37.15 / $44.67	Professional	TC	$31.62	$37.15	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $120.23	Professional		$42.66	$70.79	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $37.15 / $53.70	Professional	26	$23.44	$37.15	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $33.88 / $61.66	Professional	TC	$20.42	$33.88	$61.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $154.88	Professional		$91.20	$91.20	$154.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $123.03 / $123.03	Professional	26	$93.33	$123.03	$123.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $123.03 / $123.03	Professional	TC	$61.66	$123.03	$123.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $85.11 / $125.89	Professional		$46.77	$85.11	$125.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $44.67 / $67.61	Professional	26	$25.12	$44.67	$67.61
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.02 / $58.88	Professional	TC	$22.91	$38.02	$58.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $32.36 / $33.11	Professional		$15.49	$32.36	$33.11
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 $61.66 / $91.20 / $107.15	Professional		$61.66	$91.20	$107.15
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $47.86 / $50.12	Professional	26	$33.11	$47.86	$50.12
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $42.66 / $54.95	Professional	TC	$29.51	$42.66	$54.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $97.72	Professional		$42.66	$42.66	$97.72
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $22.91 / $48.98	Professional	26	$22.91	$22.91	$48.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $20.89 / $40.74	Professional	TC	$19.05	$20.89	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $89.13	Professional		$44.67	$50.12	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $26.30 / $48.98	Professional	26	$24.55	$26.30	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $23.44 / $43.65	Professional	TC	$19.95	$23.44	$43.65