Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $43.65 / $43.65	Facility	26	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $45.71 / $97.72	Professional		$34.67	$45.71	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.60 / $58.88	Professional	26	$12.88	$16.60	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $58.88	Professional	TC	$21.88	$28.84	$58.88
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $117.49	Professional		$72.44	$85.11	$117.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.90 / $42.66	Professional	26	$26.30	$30.90	$42.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $53.70 / $74.13	Professional	TC	$45.71	$53.70	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $85.11	Professional		$41.69	$66.07	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $25.12 / $33.11	Professional	26	$16.22	$25.12	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $41.69 / $53.70	Professional	TC	$23.99	$41.69	$53.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $363.08	Professional		$165.96	$165.96	$363.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $97.72 / $97.72	Professional	26	$33.88	$97.72	$97.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	TC	$66.07	$66.07	$66.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $89.13 / $104.71	Professional		$33.11	$89.13	$104.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $32.36 / $45.71	Professional	26	$16.60	$32.36	$45.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $58.88 / $69.18	Professional	TC	$28.84	$58.88	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $32.36 / $33.11	Professional		$12.88	$32.36	$33.11
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $112.20	Professional		$74.13	$93.33	$112.20
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $32.36 / $40.74	Professional	26	$25.12	$32.36	$40.74
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $60.26 / $72.44	Professional	TC	$44.67	$60.26	$72.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $102.33	Professional		$43.65	$43.65	$102.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $15.49 / $33.88	Professional	26	$15.49	$15.49	$33.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.11 / $58.88	Professional	TC	$28.18	$33.11	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $48.98 / $87.10	Professional		$42.66	$48.98	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $17.78 / $34.67	Professional	26	$16.60	$17.78	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.20 / $52.48	Professional	TC	$25.70	$30.20	$52.48