Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	26	$141.25	$141.25	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $831.76	Professional		$363.08	$436.52	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $107.15 / $346.74	Professional	26	$79.43	$107.15	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $354.81 / $676.08	Professional	TC	$281.84	$354.81	$676.08
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	26	$512.86	$512.86	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $831.76 / $870.96	Professional		$660.69	$831.76	$870.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $162.18 / $173.78	Professional	26	$128.82	$162.18	$173.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $660.69 / $707.95	Professional	TC	$537.03	$660.69	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $660.69 / $794.33	Professional		$354.81	$660.69	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $138.04 / $169.82	Professional	26	$91.20	$138.04	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $524.81 / $630.96	Professional	TC	$288.40	$524.81	$630.96
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $141.25 / $141.25	Facility	26	$125.89	$141.25	$141.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $831.76 / $954.99	Professional		$398.11	$831.76	$954.99
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $154.88 / $194.98	Professional	26	$87.10	$154.88	$194.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $676.08 / $776.25	Professional	TC	$288.40	$676.08	$776.25
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 Facility Modifier 26 Low / Median / High Price $512.86 / $512.86 / $512.86	Facility	26	$512.86	$512.86	$512.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $645.65 / $933.25	Professional		$478.63	$645.65	$933.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $123.03 / $190.55	Professional	26	$91.20	$123.03	$190.55
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $524.81 / $741.31	Professional	TC	$389.05	$524.81	$741.31
Select Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $478.63 / $776.25	Professional		$446.68	$478.63	$776.25
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $85.11 / $154.88	Professional	26	$85.11	$85.11	$154.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $363.08 / $602.56	Professional	TC	$354.81	$363.08	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $616.60 / $812.83	Professional		$416.87	$616.60	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $125.89 / $173.78	Professional	26	$89.13	$125.89	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $489.78 / $630.96	Professional	TC	$323.59	$489.78	$630.96