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 / $369.63	Facility	26	$147.71	$262.70	$369.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.75 / $272.73 / $565.59	Professional		$221.75	$272.73	$565.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $62.47 / $231.18	Professional	26	$44.14	$62.47	$231.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.61 / $221.14 / $372.28	Professional	TC	$177.61	$221.14	$372.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.20 / $476.19 / $700.00	Professional		$197.20	$476.19	$700.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $152.57 / $210.00	Professional	26	$70.64	$152.57	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.56 / $313.08 / $490.00	Professional	TC	$126.56	$313.08	$490.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $318.63 / $383.85 / $903.00	Professional		$318.63	$383.85	$903.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.23 / $154.68 / $343.64	Professional	26	$113.23	$154.68	$343.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.62 / $246.48 / $499.46	Professional	TC	$190.62	$246.48	$499.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $492.50 / $632.50 / $974.46	Professional		$492.50	$632.50	$974.46
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 $317.50 / $453.75 / $657.09	Professional	TC	$317.50	$453.75	$657.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $187.00 / $497.43 / $974.46	Professional		$187.00	$497.43	$974.46
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $142.00 / $213.00 / $317.37	Professional	26	$142.00	$213.00	$317.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $321.25 / $453.75 / $732.00	Professional	TC	$321.25	$453.75	$732.00
United Facility/Professional Professional Modifier Low / Median / High Price $377.42 / $566.13 / $961.04	Professional		$377.42	$566.13	$961.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $210.78 / $335.84	Professional	26	$79.00	$210.78	$335.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $236.89 / $355.35 / $649.83	Professional	TC	$236.89	$355.35	$649.83