Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $257.04 / $630.96	Facility		$158.49	$257.04	$630.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	26	$93.33	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $123.03 / $257.04	Professional		$75.86	$123.03	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $77.62 / $245.47	Professional	26	$33.11	$77.62	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $72.44 / $165.96	Professional	TC	$40.74	$72.44	$165.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $223.87 / $239.88	Professional		$204.17	$223.87	$239.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $79.43 / $83.18	Professional	26	$70.79	$79.43	$83.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $147.91 / $154.88	Professional	TC	$131.83	$147.91	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $112.20	Professional		$95.50	$95.50	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $34.67 / $40.74	Professional	26	$33.11	$34.67	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $61.66 / $72.44	Professional	TC	$61.66	$61.66	$72.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $165.96 / $257.04	Facility		$81.28	$165.96	$257.04
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	26	$93.33	$93.33	$93.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $208.93 / $223.87	Professional		$169.82	$208.93	$223.87
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $79.43	Professional	26	$47.86	$67.61	$79.43
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $141.25 / $151.36	Professional	TC	$104.71	$141.25	$151.36
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 / $213.80 / $218.78	Professional		$194.98	$213.80	$218.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $74.13	Professional	26	$70.79	$70.79	$74.13
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $141.25 / $141.25	Professional	TC	$125.89	$141.25	$141.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $112.20 / $204.17	Professional		$107.15	$112.20	$204.17
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.02 / $85.11	Professional	26	$38.02	$38.02	$85.11
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $74.13 / $134.90	Professional	TC	$69.18	$74.13	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $75.86 / $177.83	Professional		$72.44	$75.86	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.90 / $61.66	Professional	26	$26.30	$30.90	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $50.12 / $107.15	Professional	TC	$41.69	$50.12	$107.15