Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $741.31 / $933.25	Facility		$389.05	$741.31	$933.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $63.10 / $79.43	Facility	26	$60.26	$63.10	$79.43
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $323.59 / $954.99 / $1,047.13	Facility	TC	$323.59	$954.99	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $281.84 / $489.78	Professional		$190.55	$281.84	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $40.74 / $102.33	Professional	26	$26.92	$40.74	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $223.87 / $478.63	Professional	TC	$162.18	$223.87	$478.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $512.86 / $812.83	Facility		$316.23	$512.86	$812.83
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 Facility Modifier TC Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	TC	$446.68	$446.68	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $436.52 / $467.74	Professional		$371.54	$436.52	$467.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $70.79 / $75.86	Professional	26	$58.88	$70.79	$75.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $371.54 / $389.05	Professional	TC	$309.03	$371.54	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $776.25 / $1,348.96	Facility		$316.23	$776.25	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $371.54 / $645.65	Professional		$263.03	$371.54	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $56.23 / $104.71	Professional	26	$37.15	$56.23	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $323.59 / $537.03	Professional	TC	$223.87	$323.59	$537.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $575.44 / $575.44	Professional		$512.86	$575.44	$575.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $147.91 / $147.91	Professional	26	$107.15	$147.91	$147.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $426.58 / $426.58	Professional	TC	$407.38	$426.58	$426.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $354.81 / $645.65	Facility		$223.87	$354.81	$645.65
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $63.10 / $79.43	Facility	26	$54.95	$63.10	$79.43
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $281.84 / $467.74 / $1,047.13	Facility	TC	$281.84	$467.74	$1,047.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $416.87 / $524.81	Professional		$213.80	$416.87	$524.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $63.10 / $81.28	Professional	26	$35.48	$63.10	$81.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $354.81 / $446.68	Professional	TC	$194.98	$354.81	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.11 / $181.97	Professional		$29.51	$33.11	$181.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $549.54 / $812.83	Facility		$446.68	$549.54	$812.83
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 Facility Modifier TC Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	TC	$446.68	$446.68	$446.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $371.54 / $478.63	Professional		$338.84	$371.54	$478.63
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $56.23 / $69.18	Professional	26	$47.86	$56.23	$69.18
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $309.03 / $407.38	Professional	TC	$281.84	$309.03	$407.38
Select Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $245.47 / $630.96	Professional		$218.78	$245.47	$630.96
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $60.26	Professional	26	$34.67	$34.67	$60.26
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $186.21 / $331.13	Professional	TC	$186.21	$186.21	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $537.03	Professional		$257.04	$389.05	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $45.71 / $74.13	Professional	26	$33.11	$45.71	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $346.74 / $478.63	Professional	TC	$218.78	$346.74	$478.63