Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $180.78 / $184.70 / $257.24	Facility	26	$180.78	$184.70	$257.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.06 / $347.11 / $679.96	Professional		$282.06	$347.11	$679.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $61.24 / $257.24	Professional	26	$52.46	$61.24	$257.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.59 / $285.86 / $422.72	Professional	TC	$229.59	$285.86	$422.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.06 / $593.95 / $703.46	Professional		$257.06	$593.95	$703.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.34 / $186.67 / $214.08	Professional	26	$86.34	$186.67	$214.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $170.72 / $379.87 / $516.79	Professional	TC	$170.72	$379.87	$516.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $414.85 / $497.82 / $1,095.44	Professional		$414.85	$497.82	$1,095.44
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $138.28 / $169.97 / $419.71	Professional	26	$138.28	$169.97	$419.71
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $256.43 / $331.89 / $675.73	Professional	TC	$256.43	$331.89	$675.73
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $641.25 / $800.00 / $1,237.35	Professional		$641.25	$800.00	$1,237.35
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $213.75 / $230.85 / $386.66	Professional	26	$213.75	$230.85	$386.66
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $427.50 / $582.50 / $842.60	Professional	TC	$427.50	$582.50	$842.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $242.96 / $648.75 / $1,229.25	Professional		$242.96	$648.75	$1,229.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $186.67 / $259.50 / $386.66	Professional	26	$186.67	$259.50	$386.66
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $435.00 / $582.50 / $942.00	Professional	TC	$435.00	$582.50	$942.00
United Facility/Professional Professional Modifier Low / Median / High Price $475.16 / $712.74 / $1,215.54	Professional		$475.16	$712.74	$1,215.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.99 / $256.89 / $409.31	Professional	26	$82.99	$256.89	$409.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $303.89 / $455.85 / $836.48	Professional	TC	$303.89	$455.85	$836.48