Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $44.67 / $46.77	Facility	26	$25.70	$44.67	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $117.49 / $239.88	Professional		$77.62	$117.49	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $26.30 / $51.29	Professional	26	$15.85	$26.30	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $97.72 / $190.55	Professional	TC	$66.07	$97.72	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $173.78 / $245.47	Professional		$147.91	$173.78	$245.47
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $33.88 / $46.77	Professional	26	$28.84	$33.88	$46.77
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $141.25 / $199.53	Professional	TC	$120.23	$141.25	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $147.91 / $213.80	Professional		$93.33	$147.91	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $36.31	Professional	26	$19.50	$26.92	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $120.23 / $162.18	Professional	TC	$75.86	$120.23	$162.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $275.42	Professional		$245.47	$245.47	$275.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	26	$123.03	$123.03	$123.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	TC	$123.03	$123.03	$123.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $44.67 / $56.23	Facility	26	$25.70	$44.67	$56.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $177.83 / $239.88	Professional		$102.33	$177.83	$239.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $33.88 / $47.86	Professional	26	$17.38	$33.88	$47.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $141.25 / $177.83	Professional	TC	$85.11	$141.25	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $33.11 / $63.10	Professional		$14.13	$33.11	$63.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $204.17 / $239.88	Professional		$151.36	$204.17	$239.88
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $35.48 / $43.65	Professional	26	$29.51	$35.48	$43.65
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $169.82 / $194.98	Professional	TC	$120.23	$169.82	$194.98
Select Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $100.00 / $218.78	Professional		$91.20	$100.00	$218.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.60 / $37.15	Professional	26	$16.60	$16.60	$37.15
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $75.86 / $158.49	Professional	TC	$74.13	$75.86	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $204.17	Professional		$95.50	$117.49	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $19.50 / $36.31	Professional	26	$18.62	$19.50	$36.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $93.33 / $169.82	Professional	TC	$79.43	$93.33	$169.82