Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $163.82 / $285.27 / $333.16	Facility	26	$163.82	$285.27	$333.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $176.62 / $557.59	Professional		$134.40	$176.62	$557.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $60.44 / $228.23	Professional	26	$46.10	$60.44	$228.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.29 / $107.19 / $329.36	Professional	TC	$88.29	$107.19	$329.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.51 / $470.51 / $700.00	Professional		$210.51	$470.51	$700.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.02 / $164.66 / $188.48	Professional	26	$77.02	$164.66	$188.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.49 / $237.43 / $328.76	Professional	TC	$133.49	$237.43	$328.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $338.83 / $406.59 / $897.93	Professional		$338.83	$406.59	$897.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.93 / $150.75 / $372.13	Professional	26	$122.93	$150.75	$372.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $200.04 / $259.11 / $525.79	Professional	TC	$200.04	$259.11	$525.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $523.75 / $571.04 / $965.52	Professional		$523.75	$571.04	$965.52
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $190.00 / $212.80 / $342.00	Professional	26	$190.00	$212.80	$342.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $333.75 / $365.85 / $625.79	Professional	TC	$333.75	$365.85	$625.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $199.16 / $528.75 / $907.20	Professional		$199.16	$528.75	$907.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $152.00 / $228.00 / $339.72	Professional	26	$152.00	$228.00	$339.72
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $282.02 / $420.00 / $625.79	Professional	TC	$282.02	$420.00	$625.79
United Facility/Professional Professional Modifier Low / Median / High Price $238.18 / $570.39 / $911.16	Professional		$238.18	$570.39	$911.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.12 / $187.48 / $358.45	Professional	26	$80.12	$187.48	$358.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.57 / $345.78 / $752.65	Professional	TC	$103.57	$345.78	$752.65