Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.26 / $181.26 / $322.37	Facility	26	$181.26	$181.26	$322.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.68 / $347.89 / $684.24	Professional		$282.68	$347.89	$684.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.64 / $257.89	Professional	26	$52.78	$61.64	$257.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.91 / $286.25 / $426.34	Professional	TC	$229.91	$286.25	$426.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.02 / $597.98 / $706.01	Professional		$260.02	$597.98	$706.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.32 / $186.67 / $214.08	Professional	26	$87.32	$186.67	$214.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.71 / $383.90 / $519.34	Professional	TC	$172.71	$383.90	$519.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $418.88 / $502.65 / $1,125.00	Professional		$418.88	$502.65	$1,125.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $139.10 / $170.39 / $420.75	Professional	26	$139.10	$170.39	$420.75
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.44 / $335.76 / $681.56	Professional	TC	$259.44	$335.76	$681.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $647.50 / $805.00 / $1,249.42	Professional		$647.50	$805.00	$1,249.42
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $215.00 / $232.20 / $386.66	Professional	26	$215.00	$232.20	$386.66
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $432.50 / $587.50 / $851.54	Professional	TC	$432.50	$587.50	$851.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $244.50 / $653.75 / $1,238.19	Professional		$244.50	$653.75	$1,238.19
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 $438.75 / $587.50 / $948.00	Professional	TC	$438.75	$587.50	$948.00
United Facility/Professional Professional Modifier Low / Median / High Price $478.38 / $717.57 / $1,812.00	Professional		$478.38	$717.57	$1,812.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.99 / $256.89 / $563.00	Professional	26	$82.99	$256.89	$563.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.50 / $460.68 / $1,249.00	Professional	TC	$137.50	$460.68	$1,249.00