Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $331.13 / $812.83	Professional		$269.15	$331.13	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $194.98 / $323.59	Professional	26	$169.82	$194.98	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $120.23 / $199.53	Professional	TC	$93.33	$120.23	$199.53
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $549.54 / $575.44	Professional		$416.87	$549.54	$575.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $354.81 / $380.19	Professional	26	$275.42	$354.81	$380.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $186.21 / $194.98	Professional	TC	$147.91	$186.21	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $457.09 / $588.84	Professional		$331.13	$457.09	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $288.40 / $371.54	Professional	26	$208.93	$288.40	$371.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $165.96 / $213.80	Professional	TC	$125.89	$165.96	$213.80
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $524.81 / $616.60	Professional		$288.40	$524.81	$616.60
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $331.13 / $380.19	Professional	26	$181.97	$331.13	$380.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $194.98 / $234.42	Professional	TC	$107.15	$194.98	$234.42
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 $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $416.87 / $660.69	Professional		$309.03	$416.87	$660.69
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $263.03 / $407.38	Professional	26	$194.98	$263.03	$407.38
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $154.88 / $257.04	Professional	TC	$112.20	$154.88	$257.04
Select Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $288.40 / $1,023.29	Professional		$281.84	$288.40	$1,023.29
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $177.83 / $338.84	Professional	26	$177.83	$177.83	$338.84
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $102.33 / $177.83	Professional	TC	$102.33	$102.33	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $446.68 / $602.56	Professional		$316.23	$446.68	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $269.15 / $380.19	Professional	26	$194.98	$269.15	$380.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $169.82 / $223.87	Professional	TC	$117.49	$169.82	$223.87