Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.71 / $188.71 / $188.71	Facility	26	$188.71	$188.71	$188.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.43 / $430.29 / $743.01	Professional		$349.43	$430.29	$743.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.97 / $71.18 / $268.52	Professional	26	$60.97	$71.18	$268.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $288.44 / $359.11 / $474.50	Professional	TC	$288.44	$359.11	$474.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.83 / $686.26 / $973.00	Professional		$280.83	$686.26	$973.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.26 / $206.73 / $276.00	Professional	26	$90.26	$206.73	$276.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.57 / $479.53 / $681.10	Professional	TC	$190.57	$479.53	$681.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $452.85 / $543.41 / $1,191.74	Professional		$452.85	$543.41	$1,191.74
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $143.94 / $176.65 / $436.21	Professional	26	$143.94	$176.65	$436.21
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $286.49 / $370.68 / $755.54	Professional	TC	$286.49	$370.68	$755.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $700.00 / $803.60 / $1,280.66	Professional		$700.00	$803.60	$1,280.66
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $222.50 / $240.30 / $402.30	Professional	26	$222.50	$240.30	$402.30
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $477.50 / $550.20 / $878.36	Professional	TC	$477.50	$550.20	$878.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $264.33 / $717.50 / $1,213.80	Professional		$264.33	$717.50	$1,213.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $216.00 / $270.00 / $402.30	Professional	26	$216.00	$270.00	$402.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $486.25 / $643.85 / $878.36	Professional	TC	$486.25	$643.85	$878.36
United Facility/Professional Professional Modifier Low / Median / High Price $495.10 / $742.65 / $1,183.29	Professional		$495.10	$742.65	$1,183.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.36 / $222.88 / $426.14	Professional	26	$96.36	$222.88	$426.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.80 / $453.51 / $704.99	Professional	TC	$316.80	$453.51	$704.99