Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $588.84 / $616.60	Facility		$199.53	$588.84	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $138.04 / $316.23 / $912.01	Facility	TC	$138.04	$316.23	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $109.65 / $213.80	Professional		$66.07	$109.65	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $41.69 / $128.82	Professional	26	$21.88	$41.69	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $64.57 / $138.04	Professional	TC	$42.66	$64.57	$138.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $223.87	Professional		$181.97	$213.80	$223.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $66.07 / $70.79	Professional	26	$57.54	$66.07	$70.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $144.54 / $154.88	Professional	TC	$123.03	$144.54	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $95.50	Professional		$81.28	$81.28	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $28.84 / $33.88	Professional	26	$27.54	$28.84	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $61.66	Professional	TC	$52.48	$52.48	$61.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $162.18 / $588.84	Facility		$67.61	$162.18	$588.84
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $138.04 / $316.23 / $912.01	Facility	TC	$138.04	$316.23	$912.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $186.21 / $204.17	Professional		$97.72	$186.21	$204.17
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $64.57	Professional	26	$38.90	$57.54	$64.57
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $134.90 / $144.54	Professional	TC	$93.33	$134.90	$144.54
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 $165.96 / $177.83 / $186.21	Professional		$165.96	$177.83	$186.21
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $61.66	Professional	26	$58.88	$58.88	$61.66
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $117.49 / $125.89	Professional	TC	$107.15	$117.49	$125.89
Select Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $102.33 / $186.21	Professional		$100.00	$102.33	$186.21
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $66.07	Professional	26	$31.62	$31.62	$66.07
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $70.79 / $125.89	Professional	TC	$69.18	$70.79	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $64.57 / $151.36	Professional		$63.10	$64.57	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $24.55 / $51.29	Professional	26	$21.88	$24.55	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $42.66 / $97.72	Professional	TC	$38.90	$42.66	$97.72