Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $204.17	Professional		$57.54	$72.44	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $47.86 / $138.04	Professional	26	$38.90	$47.86	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.99 / $66.07	Professional	TC	$16.98	$23.99	$66.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $177.83 / $186.21	Professional		$151.36	$177.83	$186.21
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $117.49 / $123.03	Professional	26	$104.71	$117.49	$123.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $57.54 / $61.66	Professional	TC	$50.12	$57.54	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $89.13	Professional		$75.86	$75.86	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $50.12 / $60.26	Professional	26	$48.98	$50.12	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $29.51	Professional	TC	$25.12	$25.12	$29.51
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $154.88 / $162.18	Professional		$144.54	$154.88	$162.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $100.00 / $107.15	Professional	26	$72.44	$100.00	$107.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $53.70 / $56.23	Professional	TC	$43.65	$53.70	$56.23
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 $144.54 / $158.49 / $169.82	Professional		$144.54	$158.49	$169.82
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $109.65	Professional	26	$104.71	$104.71	$109.65
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $52.48 / $58.88	Professional	TC	$39.81	$52.48	$58.88
Select Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $158.49	Professional		$83.18	$83.18	$158.49
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $107.15	Professional	26	$56.23	$56.23	$107.15
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $28.18 / $57.54	Professional	TC	$27.54	$28.18	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $128.82	Professional		$54.95	$57.54	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.90 / $91.20	Professional	26	$36.31	$38.90	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.39 / $37.15	Professional	TC	$15.85	$22.39	$37.15