Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.71 / $262.70 / $395.57	Facility	26	$147.71	$262.70	$395.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.75 / $272.73 / $525.08	Professional		$221.75	$272.73	$525.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $59.66 / $262.70	Professional	26	$44.14	$59.66	$262.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.61 / $221.14 / $375.12	Professional	TC	$177.61	$221.14	$375.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.19 / $478.60 / $700.00	Professional		$198.19	$478.60	$700.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $163.12 / $210.00	Professional	26	$70.64	$163.12	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.55 / $315.49 / $490.00	Professional	TC	$127.55	$315.49	$490.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $320.23 / $385.64 / $1,003.28	Professional		$320.23	$385.64	$1,003.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.23 / $139.21 / $343.64	Professional	26	$113.23	$139.21	$343.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $192.12 / $248.43 / $505.29	Professional	TC	$192.12	$248.43	$505.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $495.00 / $647.50 / $978.93	Professional		$495.00	$647.50	$978.93
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $175.00 / $198.90 / $317.37	Professional	26	$175.00	$198.90	$317.37
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $320.00 / $457.50 / $661.56	Professional	TC	$320.00	$457.50	$661.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $188.29 / $511.22 / $978.93	Professional		$188.29	$511.22	$978.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $151.00 / $213.00 / $319.20	Professional	26	$151.00	$213.00	$319.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $325.00 / $457.50 / $740.00	Professional	TC	$325.00	$457.50	$740.00
United Facility/Professional Professional Modifier Low / Median / High Price $379.04 / $568.55 / $988.44	Professional		$379.04	$568.55	$988.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $211.99 / $489.68	Professional	26	$79.00	$211.99	$489.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $238.51 / $357.78 / $656.98	Professional	TC	$238.51	$357.78	$656.98