Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.70 / $339.20 / $464.62	Facility	26	$190.70	$339.20	$464.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.78 / $285.52 / $754.25	Professional		$232.78	$285.52	$754.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $69.65 / $271.36	Professional	26	$55.15	$69.65	$271.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.61 / $221.14 / $372.70	Professional	TC	$177.61	$221.14	$372.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.11 / $583.69 / $743.74	Professional		$243.11	$583.69	$743.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.74 / $196.38 / $210.00	Professional	26	$91.74	$196.38	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $374.59 / $547.36	Professional	TC	$151.36	$374.59	$547.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $391.40 / $472.57 / $1,040.66	Professional		$391.40	$472.57	$1,040.66
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $146.38 / $179.30 / $442.81	Professional	26	$146.38	$179.30	$442.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $227.10 / $294.02 / $597.85	Professional	TC	$227.10	$294.02	$597.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $605.00 / $818.75 / $1,260.54	Professional		$605.00	$818.75	$1,260.54
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $226.25 / $244.35 / $404.54	Professional	26	$226.25	$244.35	$404.54
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $378.75 / $554.49 / $856.01	Professional	TC	$378.75	$554.49	$856.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $230.82 / $647.15 / $1,260.54	Professional		$230.82	$647.15	$1,260.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $182.00 / $271.50 / $404.54	Professional	26	$182.00	$271.50	$404.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $385.00 / $574.50 / $954.00	Professional	TC	$385.00	$574.50	$954.00
United Facility/Professional Professional Modifier Low / Median / High Price $422.74 / $732.18 / $1,244.05	Professional		$422.74	$732.18	$1,244.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.41 / $269.07 / $586.39	Professional	26	$87.41	$269.07	$586.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $279.41 / $463.11 / $847.13	Professional	TC	$279.41	$463.11	$847.13