Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $64.57 / $74.13	Facility	26	$37.15	$64.57	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $141.25	Professional		$43.65	$57.54	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.90 / $85.11	Professional	26	$25.12	$38.90	$85.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.80 / $48.98 / $131.83	Professional	52	$13.80	$48.98	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $54.95	Professional	TC	$19.05	$25.70	$54.95
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Facility	26	$48.98	$48.98	$48.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $131.83	Professional		$83.18	$97.72	$131.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $53.70 / $75.86	Professional	26	$45.71	$53.70	$75.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $58.88	Professional	TC	$37.15	$43.65	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $107.15	Professional		$57.54	$77.62	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $43.65 / $60.26	Professional	26	$29.51	$43.65	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $46.77	Professional	TC	$25.12	$34.67	$46.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $204.17 / $204.17	Professional		$109.65	$204.17	$204.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $125.89 / $125.89	Professional	26	$112.20	$125.89	$125.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $112.20	Professional	TC	$77.62	$77.62	$112.20
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $70.79 / $89.13	Facility	26	$41.69	$70.79	$89.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $97.72 / $138.04	Professional		$51.29	$97.72	$138.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $52.48 / $77.62	Professional	26	$26.92	$52.48	$77.62
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $13.80 / $28.18 / $77.62	Professional	52	$13.80	$28.18	$77.62
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.67 / $54.95	Professional	TC	$23.99	$44.67	$54.95
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 Facility Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Facility	26	$48.98	$48.98	$48.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $104.71 / $128.82	Professional		$85.11	$104.71	$128.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $57.54 / $72.44	Professional	26	$46.77	$57.54	$72.44
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $46.77 / $56.23	Professional	TC	$39.81	$46.77	$56.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $107.15	Professional		$47.86	$47.86	$107.15
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $58.88	Professional	26	$26.92	$26.92	$58.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $24.55 / $44.67	Professional	TC	$21.38	$24.55	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $61.66 / $104.71	Professional		$57.54	$61.66	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $33.88 / $57.54	Professional	26	$30.90	$33.88	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $27.54 / $47.86	Professional	TC	$26.30	$27.54	$47.86