Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $43.65	Facility	26	$41.69	$41.69	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $489.78	Professional		$97.72	$147.91	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $44.67 / $114.82	Professional	26	$22.39	$44.67	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $89.13 / $165.96	Professional	TC	$67.61	$89.13	$165.96
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $181.97 / $190.55	Professional		$151.36	$181.97	$190.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $47.86 / $50.12	Professional	26	$39.81	$47.86	$50.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $134.90 / $141.25	Professional	TC	$112.20	$134.90	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $257.04	Professional		$109.65	$154.88	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $38.90 / $69.18	Professional	26	$26.30	$38.90	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $117.49 / $194.98	Professional	TC	$77.62	$117.49	$194.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $891.25	Professional		$602.56	$602.56	$891.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $245.47 / $245.47	Professional	26	$208.93	$245.47	$245.47
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $691.83	Professional	TC	$354.81	$354.81	$691.83
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $41.69 / $43.65	Facility	26	$36.31	$41.69	$43.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $181.97 / $316.23	Professional		$109.65	$181.97	$316.23
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $44.67 / $75.86	Professional	26	$23.99	$44.67	$75.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $134.90 / $162.18	Professional	TC	$83.18	$134.90	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $33.11 / $63.10	Professional		$19.50	$33.11	$63.10
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $151.36 / $208.93	Professional		$134.90	$151.36	$208.93
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.02 / $51.29	Professional	26	$33.88	$38.02	$51.29
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $114.82 / $158.49	Professional	TC	$102.33	$114.82	$158.49
Select Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $100.00 / $602.56	Professional		$93.33	$100.00	$602.56
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $23.99 / $42.66	Professional	26	$23.99	$23.99	$42.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $70.79 / $123.03	Professional	TC	$70.79	$70.79	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $213.80	Professional		$100.00	$147.91	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $38.02 / $50.12	Professional	26	$26.30	$38.02	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $109.65 / $147.91	Professional	TC	$74.13	$109.65	$147.91