Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.85 / $179.52 / $280.36	Facility	26	$52.85	$179.52	$280.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.59 / $219.49 / $538.26	Professional		$178.59	$219.49	$538.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.46 / $52.81 / $179.52	Professional	26	$36.46	$52.81	$179.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $142.12 / $176.95 / $291.08	Professional	TC	$142.12	$176.95	$291.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.07 / $388.11 / $700.00	Professional		$163.07	$388.11	$700.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.83 / $137.69 / $210.00	Professional	26	$60.83	$137.69	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.24 / $250.35 / $490.00	Professional	TC	$102.24	$250.35	$490.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $140.81 / $315.39 / $806.00	Professional		$140.81	$315.39	$806.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.05 / $118.91 / $292.27	Professional	26	$97.05	$118.91	$292.27
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $153.77 / $198.93 / $402.11	Professional	TC	$153.77	$198.93	$402.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $406.25 / $440.10 / $726.38	Professional		$406.25	$440.10	$726.38
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $150.00 / $162.00 / $270.44	Professional	26	$150.00	$162.00	$270.44
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $256.25 / $287.00 / $465.75	Professional	TC	$256.25	$287.00	$465.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $154.02 / $407.50 / $700.00	Professional		$154.02	$407.50	$700.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $129.88 / $181.50 / $270.44	Professional	26	$129.88	$181.50	$270.44
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $250.80 / $315.55 / $473.00	Professional	TC	$250.80	$315.55	$473.00
United Facility/Professional Professional Modifier Low / Median / High Price $282.68 / $425.58 / $678.09	Professional		$282.68	$425.58	$678.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.12 / $179.13 / $596.38	Professional	26	$58.12	$179.13	$596.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $164.30 / $247.86 / $392.68	Professional	TC	$164.30	$247.86	$392.68