Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $162.18 / $169.82	Facility	26	$162.18	$162.18	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $776.25	Professional		$316.23	$478.63	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $87.10 / $162.18	Professional	26	$66.07	$87.10	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $389.05 / $602.56	Professional	TC	$251.19	$389.05	$602.56
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	26	$2,511.89	$2,511.89	$2,511.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $562.34 / $812.83	Professional		$489.78	$562.34	$812.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $120.23 / $151.36	Professional	26	$102.33	$120.23	$151.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $436.52 / $549.54	Professional	TC	$389.05	$436.52	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $524.81 / $660.69	Professional		$467.74	$524.81	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $107.15 / $128.82	Professional	26	$95.50	$107.15	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $416.87 / $537.03	Professional	TC	$371.54	$416.87	$537.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	26	$162.18	$162.18	$162.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $549.54 / $870.96	Professional		$512.86	$549.54	$870.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $109.65 / $177.83	Professional	26	$87.10	$109.65	$177.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $436.52 / $691.83	Professional	TC	$389.05	$436.52	$691.83
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 $2,511.89 / $2,511.89 / $2,511.89	Facility	26	$2,511.89	$2,511.89	$2,511.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $645.65 / $758.58	Professional		$562.34	$645.65	$758.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $128.82 / $162.18	Professional	26	$112.20	$128.82	$162.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $512.86 / $588.84	Professional	TC	$457.09	$512.86	$588.84
Select Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $1,122.02	Professional		$288.40	$288.40	$1,122.02
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $60.26 / $131.83	Professional	26	$60.26	$60.26	$131.83
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $3,388.44	Professional	TC	$229.09	$229.09	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $363.08 / $691.83	Professional		$295.12	$363.08	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $131.83	Professional	26	$54.95	$72.44	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $295.12 / $562.34	Professional	TC	$234.42	$295.12	$562.34