Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $218.78	Professional		$107.15	$138.04	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $95.50	Professional	26	$53.70	$64.57	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $79.43 / $134.90	Professional	TC	$52.48	$79.43	$134.90
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $223.87 / $234.42	Professional		$181.97	$223.87	$234.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $114.82 / $123.03	Professional	26	$95.50	$114.82	$123.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $107.15 / $112.20	Professional	TC	$89.13	$107.15	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $316.23	Professional		$128.82	$190.55	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $89.13 / $165.96	Professional	26	$63.10	$89.13	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $97.72 / $169.82	Professional	TC	$64.57	$97.72	$169.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $588.84 / $588.84	Professional		$281.84	$588.84	$588.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $338.84 / $338.84	Professional	26	$302.00	$338.84	$338.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $245.47 / $302.00	Professional	TC	$245.47	$245.47	$302.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $213.80 / $269.15	Professional		$134.90	$213.80	$269.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $104.71 / $131.83	Professional	26	$64.57	$104.71	$131.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $112.20 / $147.91	Professional	TC	$69.18	$112.20	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $77.62	Professional		$32.36	$33.11	$77.62
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $281.84	Professional		$158.49	$177.83	$281.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $87.10 / $109.65	Professional	26	$79.43	$87.10	$109.65
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $89.13 / $181.97	Professional	TC	$79.43	$89.13	$181.97
Select Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $123.03 / $275.42	Professional		$114.82	$123.03	$275.42
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $97.72	Professional	26	$57.54	$57.54	$97.72
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $56.23 / $93.33	Professional	TC	$56.23	$56.23	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $295.12	Professional		$125.89	$199.53	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $87.10 / $117.49	Professional	26	$63.10	$87.10	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $114.82 / $186.21	Professional	TC	$61.66	$114.82	$186.21