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 / $441.90	Facility	26	$147.71	$262.70	$441.90
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 / $63.51 / $210.17	Professional	26	$44.14	$63.51	$210.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.61 / $221.14 / $314.91	Professional	TC	$177.61	$221.14	$314.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.70 / $473.80 / $564.91	Professional		$197.70	$473.80	$564.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $152.57 / $175.64	Professional	26	$70.64	$152.57	$175.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.05 / $298.16 / $412.35	Professional	TC	$127.05	$298.16	$412.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $319.43 / $383.31 / $846.95	Professional		$319.43	$383.31	$846.95
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 $191.37 / $247.44 / $503.36	Professional	TC	$191.37	$247.44	$503.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $493.75 / $635.00 / $978.93	Professional		$493.75	$635.00	$978.93
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $175.00 / $189.00 / $317.37	Professional	26	$175.00	$189.00	$317.37
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $318.75 / $456.25 / $661.56	Professional	TC	$318.75	$456.25	$661.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $187.86 / $499.40 / $978.93	Professional		$187.86	$499.40	$978.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $152.57 / $213.00 / $317.37	Professional	26	$152.57	$213.00	$317.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $323.75 / $456.25 / $736.00	Professional	TC	$323.75	$456.25	$736.00
United Facility/Professional Professional Modifier Low / Median / High Price $379.04 / $568.55 / $964.62	Professional		$379.04	$568.55	$964.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $210.78 / $335.85	Professional	26	$79.00	$210.78	$335.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.82 / $357.78 / $653.41	Professional	TC	$106.82	$357.78	$653.41