Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $67.61 / $95.50	Professional		$44.67	$67.61	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.70 / $41.69	Professional	26	$19.05	$25.70	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $60.26	Professional	TC	$25.70	$33.11	$60.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $95.50 / $100.00	Professional		$85.11	$95.50	$100.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $41.69 / $43.65	Professional	26	$35.48	$41.69	$43.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $53.70 / $57.54	Professional	TC	$50.12	$53.70	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $107.15	Professional		$50.12	$75.86	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.11 / $47.86	Professional	26	$21.88	$33.11	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $43.65 / $60.26	Professional	TC	$28.18	$43.65	$60.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $74.13 / $107.15	Facility		$54.95	$74.13	$107.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $83.18 / $128.82	Professional		$63.10	$83.18	$128.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $34.67 / $52.48	Professional	26	$28.18	$34.67	$52.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $54.95 / $83.18	Professional	TC	$41.69	$54.95	$83.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $85.11 / $123.03	Professional		$77.62	$85.11	$123.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $35.48 / $52.48	Professional	26	$33.88	$35.48	$52.48
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $48.98 / $70.79	Professional	TC	$44.67	$48.98	$70.79
Select Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $60.26 / $104.71	Professional		$56.23	$60.26	$104.71
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $25.70 / $42.66	Professional	26	$24.55	$25.70	$42.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $33.88 / $57.54	Professional	TC	$32.36	$33.88	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $117.49	Professional		$57.54	$85.11	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $32.36 / $43.65	Professional	26	$22.91	$32.36	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $50.12 / $74.13	Professional	TC	$36.31	$50.12	$74.13