Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $56.23 / $61.66	Facility	26	$29.51	$56.23	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $70.79 / $199.53	Professional		$28.84	$70.79	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $47.86 / $154.88	Professional	26	$18.20	$47.86	$154.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.18 / $70.79 / $70.79	Professional	50	$69.18	$70.79	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $25.70 / $77.62	Professional	TC	$8.91	$25.70	$77.62
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 $100.00 / $117.49 / $147.91	Professional		$100.00	$117.49	$147.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $61.66 / $67.61	Professional	26	$52.48	$61.66	$67.61
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $56.23 / $67.61	Professional	TC	$47.86	$56.23	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $81.28 / $144.54	Professional		$35.48	$81.28	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $38.02 / $51.29	Professional	26	$22.39	$38.02	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $40.74 / $61.66	Professional	TC	$11.48	$40.74	$61.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $173.78	Professional		$123.03	$123.03	$173.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Professional	26	$112.20	$112.20	$112.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $11.48 / $63.10	Professional	TC	$11.48	$11.48	$63.10
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $57.54 / $61.66	Facility	26	$33.11	$57.54	$61.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $109.65 / $151.36	Professional		$38.02	$109.65	$151.36
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $54.95 / $74.13	Professional	26	$25.12	$54.95	$74.13
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $36.31 / $70.79	Professional	50	$35.48	$36.31	$70.79
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $56.23 / $70.79	Professional	TC	$13.18	$56.23	$70.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $32.36 / $42.66	Professional		$22.39	$32.36	$42.66
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 $63.10 / $104.71 / $128.82	Professional		$63.10	$104.71	$128.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $47.86 / $67.61	Professional	26	$31.62	$47.86	$67.61
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $51.29 / $66.07	Professional	TC	$17.78	$51.29	$66.07
Select Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $60.26 / $112.20	Professional		$58.88	$60.26	$112.20
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $57.54	Professional	26	$30.90	$30.90	$57.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $29.51 / $52.48	Professional	TC	$21.88	$29.51	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $57.54 / $97.72	Professional		$34.67	$57.54	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $25.12 / $47.86	Professional	26	$23.99	$25.12	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $24.55 / $53.70	Professional	TC	$10.96	$24.55	$53.70