Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $176.75 / $307.73 / $491.40	Facility	26	$176.75	$307.73	$491.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.66 / $347.77 / $731.03	Professional		$282.66	$347.77	$731.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $74.22 / $294.17	Professional	26	$53.67	$74.22	$294.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $228.97 / $285.08 / $488.84	Professional	TC	$228.97	$285.08	$488.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.63 / $615.41 / $825.00	Professional		$254.63	$615.41	$825.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.92 / $188.96 / $247.50	Professional	26	$82.92	$188.96	$247.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.71 / $426.46 / $577.50	Professional	TC	$171.71	$426.46	$577.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $410.80 / $492.96 / $1,081.14	Professional		$410.80	$492.96	$1,081.14
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $132.63 / $162.63 / $401.50	Professional	26	$132.63	$162.63	$401.50
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.94 / $333.81 / $679.64	Professional	TC	$257.94	$333.81	$679.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $635.00 / $736.60 / $1,233.72	Professional		$635.00	$736.60	$1,233.72
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $205.00 / $231.40 / $395.60	Professional	26	$205.00	$231.40	$395.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $430.00 / $498.80 / $838.13	Professional	TC	$430.00	$498.80	$838.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.80 / $675.00 / $1,167.59	Professional		$239.80	$675.00	$1,167.59
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $190.76 / $265.50 / $395.60	Professional	26	$190.76	$265.50	$395.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $437.50 / $562.50 / $838.13	Professional	TC	$437.50	$562.50	$838.13
United Facility/Professional Professional Modifier Low / Median / High Price $445.07 / $715.98 / $1,140.79	Professional		$445.07	$715.98	$1,140.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.52 / $261.72 / $418.35	Professional	26	$84.52	$261.72	$418.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.27 / $453.42 / $722.44	Professional	TC	$302.27	$453.42	$722.44