Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $79.43 / $79.43	Facility	26	$77.62	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $147.91 / $288.40	Professional		$81.28	$147.91	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.88 / $75.86	Professional	26	$20.89	$33.88	$75.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $112.20 / $213.80	Professional	TC	$61.66	$112.20	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $257.04	Professional		$208.93	$245.47	$257.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $64.57 / $67.61	Professional	26	$56.23	$64.57	$67.61
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $177.83 / $186.21	Professional	TC	$154.88	$177.83	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $229.09	Professional		$109.65	$109.65	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $28.18 / $61.66	Professional	26	$27.54	$28.18	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $81.28 / $162.18	Professional	TC	$81.28	$81.28	$162.18
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 Professional Modifier Low / Median / High Price $147.91 / $223.87 / $257.04	Professional		$147.91	$223.87	$257.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $54.95 / $64.57	Professional	26	$33.88	$54.95	$64.57
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $165.96 / $190.55	Professional	TC	$112.20	$165.96	$190.55
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 $213.80 / $223.87 / $251.19	Professional		$213.80	$223.87	$251.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $60.26	Professional	26	$57.54	$57.54	$60.26
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $165.96 / $190.55	Professional	TC	$154.88	$165.96	$190.55
Select Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $223.87	Professional		$117.49	$117.49	$223.87
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $57.54	Professional	26	$30.90	$30.90	$57.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $87.10 / $162.18	Professional	TC	$87.10	$87.10	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $141.25	Professional		$54.95	$85.11	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $21.88 / $41.69	Professional	26	$15.49	$21.88	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $63.10 / $104.71	Professional	TC	$39.81	$63.10	$104.71