Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $190.55 / $190.55	Facility	26	$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $794.33	Professional		$194.98	$338.84	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $83.18 / $251.19	Professional	26	$58.88	$83.18	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $218.78 / $524.81	Professional	TC	$134.90	$218.78	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $851.14 / $977.24	Professional		$707.95	$851.14	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $208.93 / $295.12	Professional	26	$128.82	$208.93	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $645.65 / $676.08	Professional	TC	$457.09	$645.65	$676.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $562.34 / $912.01	Professional		$363.08	$562.34	$912.01
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $173.78 / $316.23	Professional	26	$100.00	$173.78	$316.23
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $371.54 / $660.69	Professional	TC	$316.23	$371.54	$660.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $870.96 / $1,445.44	Professional		$812.83	$870.96	$1,445.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $257.04 / $426.58	Professional	26	$218.78	$257.04	$426.58
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $562.34 / $616.60 / $1,023.29	Professional	TC	$562.34	$616.60	$1,023.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $501.19 / $851.14	Professional		$309.03	$501.19	$851.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $204.17 / $295.12	Professional	26	$50.12	$204.17	$295.12
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $457.09 / $676.08	Professional	TC	$151.36	$457.09	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $851.14 / $1,862.09	Professional		$562.34	$851.14	$1,862.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $288.40 / $630.96	Professional	26	$151.36	$288.40	$630.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $562.34 / $1,412.54	Professional	TC	$371.54	$562.34	$1,412.54