Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $151.36 / $151.36	Facility		$66.07	$151.36	$151.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $41.69 / $66.07	Professional		$19.05	$41.69	$66.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $8.13 / $16.22	Professional	26	$3.98	$8.13	$16.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $31.62 / $51.29	Professional	TC	$14.13	$31.62	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $66.07	Professional		$53.70	$61.66	$66.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.88 / $13.49	Professional	26	$11.48	$12.88	$13.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $48.98 / $51.29	Professional	TC	$42.66	$48.98	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $28.18	Professional		$23.99	$23.99	$28.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $5.50 / $6.46	Professional	26	$5.50	$5.50	$6.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $18.62 / $21.88	Professional	TC	$18.62	$18.62	$21.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $54.95 / $134.90	Facility		$33.11	$54.95	$134.90
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $60.26	Professional		$42.66	$53.70	$60.26
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.75 / $12.30	Professional	26	$8.13	$11.75	$12.30
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $44.67 / $47.86	Professional	TC	$31.62	$44.67	$47.86
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 Professional Modifier Low / Median / High Price $50.12 / $53.70 / $60.26	Professional		$50.12	$53.70	$60.26
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $11.75 / $12.30	Professional	26	$11.48	$11.75	$12.30
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $42.66 / $47.86	Professional	TC	$38.02	$42.66	$47.86
Select Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $30.20 / $74.13	Professional		$29.51	$30.20	$74.13
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.31 / $11.75	Professional	26	$6.17	$6.31	$11.75
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $23.44 / $64.57	Professional	TC	$23.44	$23.44	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.90 / $43.65	Professional		$19.05	$30.90	$43.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $4.37 / $10.00	Professional	26	$3.89	$4.37	$10.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $23.99 / $33.88	Professional	TC	$14.45	$23.99	$33.88