Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $63.10	Facility	26	$54.95	$54.95	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $69.18 / $181.97	Professional		$38.90	$69.18	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $27.54 / $54.95	Professional	26	$22.91	$27.54	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $53.70	Professional	TC	$15.14	$22.91	$53.70
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	26	$245.47	$245.47	$245.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $112.20	Professional		$64.57	$75.86	$112.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $45.71 / $48.98	Professional	26	$38.90	$45.71	$48.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.20 / $32.36	Professional	TC	$25.70	$30.20	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $70.79 / $107.15	Professional		$57.54	$70.79	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $36.31 / $52.48	Professional	26	$29.51	$36.31	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $31.62 / $72.44	Professional	TC	$23.99	$31.62	$72.44
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Facility	26	$54.95	$54.95	$54.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $70.79 / $128.82	Professional		$67.61	$70.79	$128.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $41.69 / $66.07	Professional	26	$29.51	$41.69	$66.07
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $29.51 / $85.11	Professional	TC	$28.18	$29.51	$85.11
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 $245.47 / $245.47 / $245.47	Facility	26	$245.47	$245.47	$245.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $79.43 / $83.18	Professional		$69.18	$79.43	$83.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $46.77 / $48.98	Professional	26	$42.66	$46.77	$48.98
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $29.51 / $36.31	Professional	TC	$26.92	$29.51	$36.31
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $467.74	Professional		$38.02	$38.02	$467.74
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $22.91 / $52.48	Professional	26	$22.91	$22.91	$52.48
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $15.85 / $323.59	Professional	TC	$15.49	$15.85	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $95.50 / $165.96	Professional		$51.29	$95.50	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.11 / $57.54	Professional	26	$25.70	$33.11	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $63.10 / $109.65	Professional	TC	$25.12	$63.10	$109.65