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 / $262.85	Facility	26	$147.71	$262.70	$262.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.44 / $272.42 / $689.00	Professional		$221.44	$272.42	$689.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $78.81 / $262.70	Professional	26	$43.82	$78.81	$262.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.61 / $221.14 / $459.77	Professional	TC	$177.61	$221.14	$459.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.84 / $560.87 / $700.00	Professional		$244.84	$560.87	$700.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $153.62 / $210.00	Professional	26	$70.64	$153.62	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.19 / $407.25 / $490.00	Professional	TC	$174.19	$407.25	$490.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $394.72 / $474.51 / $1,035.82	Professional		$394.72	$474.51	$1,035.82
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 $261.70 / $338.67 / $692.18	Professional	TC	$261.70	$338.67	$692.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $611.25 / $669.60 / $1,124.21	Professional		$611.25	$669.60	$1,124.21
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 $436.25 / $480.60 / $806.84	Professional	TC	$436.25	$480.60	$806.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $229.74 / $620.00 / $1,066.80	Professional		$229.74	$620.00	$1,066.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $144.00 / $213.00 / $317.37	Professional	26	$144.00	$213.00	$317.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $407.25 / $541.50 / $806.84	Professional	TC	$407.25	$541.50	$806.84
United Facility/Professional Professional Modifier Low / Median / High Price $377.79 / $647.25 / $1,031.29	Professional		$377.79	$647.25	$1,031.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.28 / $140.52 / $312.50	Professional	26	$120.28	$140.52	$312.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $290.98 / $293.24 / $695.44	Professional	TC	$290.98	$293.24	$695.44