Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $194.98	Facility	26	$97.72	$97.72	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $371.54 / $660.69	Professional		$190.55	$371.54	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $112.20 / $181.97	Professional	26	$61.66	$112.20	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $239.88 / $371.54	Professional	TC	$125.89	$239.88	$371.54
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $407.38 / $562.34	Professional		$346.74	$407.38	$562.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $141.25 / $199.53	Professional	26	$120.23	$141.25	$199.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $263.03 / $371.54	Professional	TC	$223.87	$263.03	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $575.44	Professional		$190.55	$275.42	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $151.36	Professional	26	$63.10	$83.18	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $177.83 / $309.03	Professional	TC	$128.82	$177.83	$309.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,202.26	Professional		$1,096.48	$1,096.48	$1,202.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $549.54 / $549.54 / $549.54	Professional	26	$549.54	$549.54	$549.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $537.03 / $537.03	Professional	TC	$537.03	$537.03	$537.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $190.55 / $190.55	Facility	26	$97.72	$190.55	$190.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $602.56	Professional		$281.84	$426.58	$602.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $181.97	Professional	26	$85.11	$141.25	$181.97
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $281.84 / $398.11	Professional	TC	$173.78	$281.84	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $457.09 / $549.54	Professional		$346.74	$457.09	$549.54
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $151.36 / $190.55	Professional	26	$123.03	$151.36	$190.55
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $309.03 / $363.08	Professional	TC	$213.80	$309.03	$363.08
Select Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $489.78	Professional		$199.53	$199.53	$489.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $158.49	Professional	26	$70.79	$70.79	$158.49
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $134.90 / $478.63	Professional	TC	$131.83	$134.90	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $457.09 / $1,230.27	Professional		$218.78	$457.09	$1,230.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $81.28 / $154.88	Professional	26	$67.61	$81.28	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $323.59 / $1,096.48	Professional	TC	$147.91	$323.59	$1,096.48