Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $194.98 / $194.98	Facility	26	$190.55	$194.98	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $537.03 / $870.96	Professional		$354.81	$537.03	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $87.10 / $169.82	Professional	26	$69.18	$87.10	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $457.09 / $707.95	Professional	TC	$281.84	$457.09	$707.95
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $707.95 / $891.25	Professional		$602.56	$707.95	$891.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $138.04 / $173.78	Professional	26	$117.49	$138.04	$173.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $575.44 / $707.95	Professional	TC	$478.63	$575.44	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $676.08 / $741.31	Professional		$602.56	$676.08	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $123.03 / $154.88	Professional	26	$107.15	$123.03	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $537.03 / $616.60	Professional	TC	$501.19	$537.03	$616.60
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $194.98 / $194.98	Facility	26	$194.98	$194.98	$194.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $676.08 / $1,071.52	Professional		$630.96	$676.08	$1,071.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $123.03 / $199.53	Professional	26	$112.20	$123.03	$199.53
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $549.54 / $870.96	Professional	TC	$512.86	$549.54	$870.96
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 $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $812.83 / $977.24	Professional		$724.44	$812.83	$977.24
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $147.91 / $181.97	Professional	26	$128.82	$147.91	$181.97
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $602.56 / $676.08 / $794.33	Professional	TC	$602.56	$676.08	$794.33
Select Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $794.33	Professional		$354.81	$354.81	$794.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $151.36	Professional	26	$67.61	$67.61	$151.36
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $288.40 / $1,380.38	Professional	TC	$288.40	$288.40	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $416.87 / $851.14	Professional		$338.84	$416.87	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $83.18 / $147.91	Professional	26	$66.07	$83.18	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $331.13 / $676.08	Professional	TC	$275.42	$331.13	$676.08