Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $489.78 / $758.58	Facility		$234.42	$489.78	$758.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $67.61 / $75.86	Facility	26	$38.90	$67.61	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $141.25 / $281.84	Professional		$83.18	$141.25	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $36.31 / $67.61	Professional	26	$25.70	$36.31	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $125.89 / $213.80	Professional	TC	$54.95	$125.89	$213.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $269.15 / $407.38	Facility		$138.04	$269.15	$407.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $208.93	Professional		$177.83	$208.93	$208.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $50.12 / $50.12	Professional	26	$42.66	$50.12	$50.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $158.49 / $158.49	Professional	TC	$134.90	$158.49	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $218.78	Professional		$112.20	$173.78	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $47.86 / $53.70	Professional	26	$33.11	$47.86	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $123.03 / $162.18	Professional	TC	$79.43	$123.03	$162.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $281.84 / $758.58	Facility		$141.25	$281.84	$758.58
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $64.57 / $83.18	Facility	26	$38.90	$64.57	$83.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $213.80 / $239.88	Professional		$131.83	$213.80	$239.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $47.86 / $54.95	Professional	26	$30.20	$47.86	$54.95
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $165.96 / $190.55	Professional	TC	$85.11	$165.96	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $239.88 / $281.84	Professional		$162.18	$239.88	$281.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $53.70 / $66.07	Professional	26	$37.15	$53.70	$66.07
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $186.21 / $213.80	Professional	TC	$123.03	$186.21	$213.80
Select Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $269.15	Professional		$112.20	$112.20	$269.15
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $53.70	Professional	26	$25.70	$25.70	$53.70
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $87.10 / $154.88	Professional	TC	$81.28	$87.10	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $151.36	Professional		$75.86	$109.65	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $28.18 / $50.12	Professional	26	$26.30	$28.18	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $81.28 / $107.15	Professional	TC	$50.12	$81.28	$107.15