Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Facility	26	$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $218.78 / $575.44	Professional		$208.93	$218.78	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $81.28	Professional	26	$26.92	$33.88	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $190.55 / $489.78	Professional	TC	$181.97	$190.55	$489.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $512.86 / $537.03	Professional		$457.09	$512.86	$537.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $81.28 / $85.11	Professional	26	$70.79	$81.28	$85.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $426.58 / $457.09	Professional	TC	$389.05	$426.58	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $316.23	Professional		$263.03	$263.03	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $36.31 / $42.66	Professional	26	$34.67	$36.31	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $269.15	Professional	TC	$229.09	$229.09	$269.15
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Facility	26	$97.72	$97.72	$97.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $467.74 / $489.78	Professional		$436.52	$467.74	$489.78
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $69.18 / $72.44	Professional	26	$64.57	$69.18	$72.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $398.11 / $416.87	Professional	TC	$371.54	$398.11	$416.87
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 $501.19 / $501.19 / $562.34	Professional		$501.19	$501.19	$562.34
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $72.44 / $75.86	Professional	26	$70.79	$72.44	$75.86
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $436.52 / $489.78	Professional	TC	$426.58	$436.52	$489.78
Select Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $245.47 / $501.19	Professional		$239.88	$245.47	$501.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.90 / $72.44	Professional	26	$38.02	$38.90	$72.44
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $208.93 / $426.58	Professional	TC	$204.17	$208.93	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $208.93 / $346.74	Professional		$117.49	$208.93	$346.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $27.54 / $45.71	Professional	26	$25.70	$27.54	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $181.97 / $302.00	Professional	TC	$91.20	$181.97	$302.00