Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.71 / $268.51 / $335.64	Facility	26	$188.71	$268.51	$335.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.67 / $346.44 / $700.87	Professional		$281.67	$346.44	$700.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $64.06 / $268.52	Professional	26	$54.86	$64.06	$268.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.80 / $282.38 / $432.36	Professional	TC	$226.80	$282.38	$432.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.95 / $642.83 / $973.00	Professional		$264.95	$642.83	$973.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.76 / $207.94 / $276.00	Professional	26	$90.76	$207.94	$276.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.19 / $434.90 / $681.10	Professional	TC	$174.19	$434.90	$681.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $426.98 / $512.37 / $1,127.50	Professional		$426.98	$512.37	$1,127.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.75 / $177.41 / $438.13	Professional	26	$144.75	$177.41	$438.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $261.70 / $338.67 / $689.37	Professional	TC	$261.70	$338.67	$689.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.00 / $720.90 / $1,202.43	Professional		$660.00	$720.90	$1,202.43
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $223.75 / $241.65 / $402.30	Professional	26	$223.75	$241.65	$402.30
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $436.25 / $479.25 / $800.13	Professional	TC	$436.25	$479.25	$800.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $250.08 / $667.50 / $1,138.20	Professional		$250.08	$667.50	$1,138.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $194.34 / $270.00 / $402.30	Professional	26	$194.34	$270.00	$402.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $432.00 / $541.50 / $800.13	Professional	TC	$432.00	$541.50	$800.13
United Facility/Professional Professional Modifier Low / Median / High Price $466.86 / $505.55 / $1,038.23	Professional		$466.86	$505.55	$1,038.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.93 / $267.45 / $426.14	Professional	26	$86.93	$267.45	$426.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $288.56 / $432.84 / $689.66	Professional	TC	$288.56	$432.84	$689.66