Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $74.13 / $81.28	Facility	26	$39.81	$74.13	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $134.90 / $575.44	Professional		$83.18	$134.90	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $56.23 / $141.25	Professional	26	$28.18	$56.23	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $95.50 / $190.55	Professional	TC	$57.54	$95.50	$190.55
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 $154.88 / $181.97 / $229.09	Professional		$154.88	$181.97	$229.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $57.54 / $64.57	Professional	26	$48.98	$57.54	$64.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $125.89 / $151.36	Professional	TC	$107.15	$125.89	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $151.36 / $269.15	Professional		$89.13	$151.36	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $46.77 / $83.18	Professional	26	$30.20	$46.77	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $107.15 / $186.21	Professional	TC	$60.26	$107.15	$186.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $309.03	Professional		$257.04	$309.03	$309.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	26	$144.54	$144.54	$144.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $162.18 / $162.18	Professional	TC	$112.20	$162.18	$162.18
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $77.62 / $81.28	Facility	26	$43.65	$77.62	$81.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $245.47	Professional		$109.65	$177.83	$245.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $54.95 / $83.18	Professional	26	$30.20	$54.95	$83.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $125.89 / $151.36	Professional	TC	$77.62	$125.89	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $77.62	Professional		$23.99	$33.11	$77.62
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 $141.25 / $204.17 / $229.09	Professional		$141.25	$204.17	$229.09
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $61.66 / $64.57	Professional	26	$41.69	$61.66	$64.57
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $141.25 / $173.78	Professional	TC	$97.72	$141.25	$173.78
Select Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $223.87	Professional		$91.20	$91.20	$223.87
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $28.18 / $63.10	Professional	26	$28.18	$28.18	$63.10
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $64.57 / $138.04	Professional	TC	$63.10	$64.57	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $251.19	Professional		$107.15	$125.89	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $33.11 / $63.10	Professional	26	$31.62	$33.11	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $95.50 / $190.55	Professional	TC	$74.13	$95.50	$190.55