Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $180.78 / $180.78 / $321.55	Facility	26	$180.78	$180.78	$321.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.06 / $347.11 / $681.17	Professional		$282.06	$347.11	$681.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.64 / $257.24	Professional	26	$52.78	$61.64	$257.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.28 / $285.48 / $423.93	Professional	TC	$229.28	$285.48	$423.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.06 / $623.75 / $825.00	Professional		$258.06	$623.75	$825.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.34 / $198.50 / $247.50	Professional	26	$86.34	$198.50	$247.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.71 / $425.25 / $577.50	Professional	TC	$171.71	$425.25	$577.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $416.45 / $499.74 / $1,097.35	Professional		$416.45	$499.74	$1,097.35
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 $257.94 / $333.81 / $677.66	Professional	TC	$257.94	$333.81	$677.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $643.75 / $801.25 / $1,242.18	Professional		$643.75	$801.25	$1,242.18
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 $430.00 / $583.75 / $844.83	Professional	TC	$430.00	$583.75	$844.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $243.40 / $673.00 / $1,231.49	Professional		$243.40	$673.00	$1,231.49
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 $436.25 / $577.50 / $942.00	Professional	TC	$436.25	$577.50	$942.00
United Facility/Professional Professional Modifier Low / Median / High Price $475.96 / $713.94 / $1,215.54	Professional		$475.96	$713.94	$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 $304.69 / $457.05 / $836.48	Professional	TC	$304.69	$457.05	$836.48