Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $208.93 / $331.13	Facility	26	$151.36	$208.93	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $263.03 / $562.34	Professional		$141.25	$263.03	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $194.98	Professional	26	$47.86	$67.61	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $169.82 / $354.81	Professional	TC	$91.20	$169.82	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $478.63 / $707.95	Professional		$457.09	$478.63	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $162.18 / $208.93	Professional	26	$100.00	$162.18	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $323.59 / $489.78	Professional	TC	$295.12	$323.59	$489.78
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $208.93 / $398.11	Facility	26	$151.36	$208.93	$398.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $660.69	Professional		$239.88	$380.19	$660.69
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $138.04 / $257.04	Professional	26	$54.95	$138.04	$257.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $239.88 / $416.87	Professional	TC	$165.96	$239.88	$416.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $676.08 / $977.24	Professional		$537.03	$676.08	$977.24
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $199.53 / $316.23	Professional	26	$173.78	$199.53	$316.23
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $457.09 / $660.69	Professional	TC	$354.81	$457.09	$660.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $478.63	Professional		$229.09	$338.84	$478.63
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $138.04 / $208.93	Professional	26	$39.81	$138.04	$208.93
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $295.12 / $489.78	Professional	TC	$123.03	$295.12	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $562.34 / $1,445.44	Professional		$380.19	$562.34	$1,445.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $208.93 / $489.78	Professional	26	$120.23	$208.93	$489.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $363.08 / $1,148.15	Professional	TC	$239.88	$363.08	$1,148.15