Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.70 / $193.52 / $457.59	Facility	26	$190.70	$193.52	$457.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.78 / $285.52 / $612.76	Professional		$232.78	$285.52	$612.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $64.39 / $271.36	Professional	26	$55.15	$64.39	$271.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.61 / $221.14 / $341.40	Professional	TC	$177.61	$221.14	$341.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.22 / $552.33 / $700.00	Professional		$229.22	$552.33	$700.00
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 $137.47 / $343.23 / $490.00	Professional	TC	$137.47	$343.23	$490.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $369.55 / $448.90 / $987.03	Professional		$369.55	$448.90	$987.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $146.38 / $179.30 / $440.83	Professional	26	$146.38	$179.30	$440.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $207.15 / $267.83 / $546.15	Professional	TC	$207.15	$267.83	$546.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $571.25 / $648.20 / $1,034.81	Professional		$571.25	$648.20	$1,034.81
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $226.25 / $244.35 / $406.77	Professional	26	$226.25	$244.35	$406.77
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $345.00 / $395.00 / $628.04	Professional	TC	$345.00	$395.00	$628.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $218.93 / $576.25 / $999.60	Professional		$218.93	$576.25	$999.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $182.00 / $273.00 / $406.77	Professional	26	$182.00	$273.00	$406.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $351.25 / $462.92 / $628.04	Professional	TC	$351.25	$462.92	$628.04
United Facility/Professional Professional Modifier Low / Median / High Price $385.21 / $609.90 / $971.77	Professional		$385.21	$609.90	$971.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.41 / $270.27 / $430.63	Professional	26	$87.41	$270.27	$430.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $226.42 / $339.63 / $541.14	Professional	TC	$226.42	$339.63	$541.14