Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $144.54 / $144.54	Facility	26	$138.04	$144.54	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $1,071.52	Professional		$223.87	$309.03	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $128.82 / $346.74	Professional	26	$77.62	$128.82	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $177.83 / $275.42	Professional	TC	$138.04	$177.83	$275.42
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $933.25 / $933.25 / $933.25	Facility	26	$933.25	$933.25	$933.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $457.09	Professional		$363.08	$436.52	$457.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $158.49 / $165.96	Professional	26	$131.83	$158.49	$165.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $275.42 / $288.40	Professional	TC	$229.09	$275.42	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $616.60	Professional		$239.88	$354.81	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $128.82 / $229.09	Professional	26	$89.13	$128.82	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $234.42 / $380.19	Professional	TC	$158.49	$234.42	$380.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $831.76 / $831.76	Professional		$676.08	$831.76	$831.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $316.23 / $316.23	Professional	26	$316.23	$316.23	$316.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $512.86 / $512.86	Professional	TC	$363.08	$512.86	$512.86
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $144.54	Facility	26	$138.04	$138.04	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $407.38 / $512.86	Professional		$257.04	$407.38	$512.86
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $144.54 / $181.97	Professional	26	$87.10	$144.54	$181.97
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $269.15 / $338.84	Professional	TC	$169.82	$269.15	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $151.36	Professional		$32.36	$33.11	$151.36
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $933.25 / $933.25 / $933.25	Facility	26	$933.25	$933.25	$933.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $354.81 / $489.78	Professional		$323.59	$354.81	$489.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $125.89 / $169.82	Professional	26	$112.20	$125.89	$169.82
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $234.42 / $323.59	Professional	TC	$208.93	$234.42	$323.59
Select Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $239.88 / $1,412.54	Professional		$218.78	$239.88	$1,412.54
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $141.25	Professional	26	$77.62	$77.62	$141.25
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $138.04 / $239.88	Professional	TC	$138.04	$138.04	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $489.78	Professional		$239.88	$354.81	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $125.89 / $165.96	Professional	26	$87.10	$125.89	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $223.87 / $302.00	Professional	TC	$151.36	$223.87	$302.00