Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.79 / $82.79 / $189.54	Facility	26	$82.79	$82.79	$189.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $159.40 / $385.23	Professional		$97.57	$159.40	$385.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.64 / $41.62 / $91.17	Professional	26	$23.64	$41.62	$91.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.93 / $129.04 / $294.06	Professional	TC	$73.93	$129.04	$294.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.10 / $289.56 / $475.08	Professional		$194.10	$289.56	$475.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $84.40 / $96.05	Professional	26	$40.74	$84.40	$96.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.36 / $205.16 / $383.03	Professional	TC	$153.36	$205.16	$383.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $313.19 / $376.50 / $806.25	Professional		$313.19	$376.50	$806.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.70 / $78.34 / $226.79	Professional	26	$64.70	$78.34	$226.79
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $236.59 / $298.89 / $725.99	Professional	TC	$236.59	$298.89	$725.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $390.00 / $533.25 / $757.67	Professional		$390.00	$533.25	$757.67
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.50 / $108.00 / $174.33	Professional	26	$97.50	$108.00	$174.33
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $292.50 / $426.60 / $583.34	Professional	TC	$292.50	$426.60	$583.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $171.43 / $390.00 / $691.20	Professional		$171.43	$390.00	$691.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $117.00 / $178.23	Professional	26	$79.00	$117.00	$178.23
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $251.22 / $395.00 / $583.34	Professional	TC	$251.22	$395.00	$583.34
United Facility/Professional Professional Modifier Low / Median / High Price $161.81 / $287.14 / $617.35	Professional		$161.81	$287.14	$617.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $96.05 / $193.17	Professional	26	$36.82	$96.05	$193.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.99 / $250.47 / $459.19	Professional	TC	$124.99	$250.47	$459.19