Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $144.54	Facility	26	$141.25	$141.25	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $346.74	Professional		$181.97	$213.80	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $77.62 / $173.78	Professional	26	$57.54	$77.62	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $147.91 / $229.09	Professional	TC	$120.23	$147.91	$229.09
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 $275.42 / $323.59 / $467.74	Professional		$275.42	$323.59	$467.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $104.71 / $131.83	Professional	26	$89.13	$104.71	$131.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $213.80 / $269.15	Professional	TC	$181.97	$213.80	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $275.42 / $323.59	Professional		$245.47	$275.42	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $93.33 / $109.65	Professional	26	$83.18	$93.33	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $181.97 / $213.80	Professional	TC	$162.18	$181.97	$213.80
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $141.25 / $144.54	Facility	26	$125.89	$141.25	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $478.63	Professional		$275.42	$346.74	$478.63
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $95.50 / $151.36	Professional	26	$85.11	$95.50	$151.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $208.93 / $331.13	Professional	TC	$169.82	$208.93	$331.13
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 $309.03 / $354.81 / $416.87	Professional		$309.03	$354.81	$416.87
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $112.20 / $141.25	Professional	26	$97.72	$112.20	$141.25
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $239.88 / $275.42	Professional	TC	$213.80	$239.88	$275.42
Select Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $776.25	Professional		$158.49	$158.49	$776.25
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $120.23	Professional	26	$52.48	$52.48	$120.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $107.15 / $1,380.38	Professional	TC	$107.15	$107.15	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $346.74	Professional		$147.91	$190.55	$346.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $114.82	Professional	26	$48.98	$61.66	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $131.83 / $229.09	Professional	TC	$100.00	$131.83	$229.09