Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $205.64 / $365.75 / $388.35	Facility	26	$205.64	$365.75	$388.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.16 / $345.42 / $837.00	Professional		$281.16	$345.42	$837.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $100.73 / $292.60	Professional	26	$59.34	$100.73	$292.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $221.81 / $276.17 / $473.56	Professional	TC	$221.81	$276.17	$473.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.75 / $683.37 / $825.00	Professional		$280.75	$683.37	$825.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.12 / $225.55 / $247.50	Professional	26	$98.12	$225.55	$247.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.63 / $457.82 / $577.50	Professional	TC	$182.63	$457.82	$577.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $452.85 / $543.79 / $1,200.05	Professional		$452.85	$543.79	$1,200.05
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $156.88 / $192.58 / $475.64	Professional	26	$156.88	$192.58	$475.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $274.47 / $355.17 / $724.41	Professional	TC	$274.47	$355.17	$724.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $700.00 / $799.40 / $1,273.95	Professional		$700.00	$799.40	$1,273.95
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $242.50 / $261.89 / $438.06	Professional	26	$242.50	$261.89	$438.06
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $457.50 / $523.60 / $835.89	Professional	TC	$457.50	$523.60	$835.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $266.17 / $708.75 / $1,207.50	Professional		$266.17	$708.75	$1,207.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $211.72 / $294.00 / $438.06	Professional	26	$211.72	$294.00	$438.06
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $466.25 / $570.00 / $835.89	Professional	TC	$466.25	$570.00	$835.89
United Facility/Professional Professional Modifier Low / Median / High Price $459.49 / $743.58 / $1,184.77	Professional		$459.49	$743.58	$1,184.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.88 / $291.20 / $464.23	Professional	26	$93.88	$291.20	$464.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $301.48 / $452.22 / $720.54	Professional	TC	$301.48	$452.22	$720.54