Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $194.98 / $194.98	Facility	26	$194.98	$194.98	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $89.13 / $208.93	Professional		$79.43	$89.13	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $162.18	Professional	26	$52.48	$64.57	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $57.54	Professional	TC	$19.95	$32.36	$57.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $223.87 / $239.88	Professional		$199.53	$223.87	$239.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $169.82 / $177.83	Professional	26	$147.91	$169.82	$177.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $54.95 / $58.88	Professional	TC	$50.12	$54.95	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $107.15	Professional		$91.20	$91.20	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $72.44 / $85.11	Professional	26	$69.18	$72.44	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $23.44	Professional	TC	$19.95	$19.95	$23.44
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 $186.21 / $199.53 / $208.93	Professional		$186.21	$199.53	$208.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $144.54 / $154.88	Professional	26	$138.04	$144.54	$154.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $52.48 / $54.95	Professional	TC	$45.71	$52.48	$54.95
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 $194.98 / $199.53 / $208.93	Professional		$194.98	$199.53	$208.93
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $151.36 / $154.88	Professional	26	$144.54	$151.36	$154.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $51.29 / $53.70	Professional	TC	$45.71	$51.29	$53.70
Select Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $223.87	Professional		$107.15	$107.15	$223.87
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $154.88	Professional	26	$81.28	$81.28	$154.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $26.92 / $81.28	Professional	TC	$26.30	$26.92	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $83.18 / $165.96	Professional		$70.79	$83.18	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $54.95 / $125.89	Professional	26	$48.98	$54.95	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $26.92 / $37.15	Professional	TC	$15.85	$26.92	$37.15