Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $446.68 / $691.83	Facility		$234.42	$446.68	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Facility	26	$25.12	$25.12	$25.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $61.66 / $478.63 / $741.31	Facility	TC	$61.66	$478.63	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $57.54 / $87.10	Professional		$25.12	$57.54	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.02 / $46.77	Professional	26	$7.08	$12.02	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $52.48 / $61.66	Professional	TC	$18.20	$52.48	$61.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $79.43 / $85.11	Professional		$69.18	$79.43	$85.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.38 / $22.91	Professional	26	$19.05	$21.38	$22.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $58.88 / $61.66	Professional	TC	$51.29	$58.88	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $38.02	Professional		$32.36	$32.36	$38.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.33 / $10.96	Professional	26	$9.12	$9.33	$10.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $22.91 / $26.92	Professional	TC	$22.91	$22.91	$26.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $100.00 / $524.81	Facility		$46.77	$100.00	$524.81
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Facility	26	$25.12	$25.12	$25.12
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $61.66 / $478.63 / $741.31	Facility	TC	$61.66	$478.63	$741.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $75.86	Professional		$42.66	$72.44	$75.86
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.98 / $21.38	Professional	26	$10.23	$16.98	$21.38
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $53.70 / $61.66	Professional	TC	$38.90	$53.70	$61.66
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 $66.07 / $69.18 / $77.62	Professional		$66.07	$69.18	$77.62
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.50 / $20.42	Professional	26	$19.05	$19.50	$20.42
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $51.29 / $57.54	Professional	TC	$46.77	$51.29	$57.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $93.33	Professional		$38.02	$38.02	$93.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.23 / $19.50	Professional	26	$10.00	$10.23	$19.50
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $28.18 / $77.62	Professional	TC	$27.54	$28.18	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $37.15 / $58.88	Professional		$25.12	$37.15	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.08 / $16.60	Professional	26	$6.46	$7.08	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $29.51 / $41.69	Professional	TC	$17.78	$29.51	$41.69