Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $281.84	Facility	26	$141.25	$141.25	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $1,288.25	Professional		$316.23	$478.63	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $147.91 / $467.74	Professional	26	$93.33	$147.91	$467.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $338.84 / $562.34	Professional	TC	$213.80	$338.84	$562.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $630.96 / $891.25	Professional		$537.03	$630.96	$891.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $204.17 / $288.40	Professional	26	$173.78	$204.17	$288.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $426.58 / $602.56	Professional	TC	$363.08	$426.58	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $776.25	Professional		$302.00	$426.58	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $117.49 / $213.80	Professional	26	$91.20	$117.49	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $295.12 / $501.19	Professional	TC	$208.93	$295.12	$501.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,659.59 / $1,659.59	Professional		$1,318.26	$1,659.59	$1,659.59
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $891.25 / $891.25 / $891.25	Professional	26	$891.25	$891.25	$891.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $776.25 / $776.25 / $776.25	Professional	TC	$776.25	$776.25	$776.25
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $275.42 / $275.42	Facility	26	$141.25	$275.42	$275.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $645.65 / $954.99	Professional		$389.05	$645.65	$954.99
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $199.53 / $295.12	Professional	26	$112.20	$199.53	$295.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $446.68 / $575.44	Professional	TC	$257.04	$446.68	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $707.95 / $870.96	Professional		$549.54	$707.95	$870.96
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $218.78 / $275.42	Professional	26	$177.83	$218.78	$275.42
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $501.19 / $588.84	Professional	TC	$354.81	$501.19	$588.84
Select Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $707.95	Professional		$316.23	$316.23	$707.95
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $229.09	Professional	26	$102.33	$102.33	$229.09
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $478.63	Professional	TC	$213.80	$213.80	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $630.96 / $1,318.26	Professional		$346.74	$630.96	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $117.49 / $199.53	Professional	26	$70.79	$117.49	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $489.78 / $1,122.02	Professional	TC	$245.47	$489.78	$1,122.02