Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.18 / $172.18 / $172.18	Facility	26	$172.18	$172.18	$172.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $272.22 / $335.06 / $891.67	Professional		$272.22	$335.06	$891.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $58.49 / $244.98	Professional	26	$50.07	$58.49	$244.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $222.12 / $276.56 / $557.57	Professional	TC	$222.12	$276.56	$557.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.26 / $750.51 / $825.00	Professional		$304.26	$750.51	$825.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.42 / $187.76 / $247.50	Professional	26	$82.42	$187.76	$247.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.84 / $548.79 / $577.50	Professional	TC	$221.84	$548.79	$577.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $488.50 / $590.01 / $1,283.58	Professional		$488.50	$590.01	$1,283.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.80 / $161.84 / $399.58	Professional	26	$131.80	$161.84	$399.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $333.87 / $431.82 / $884.02	Professional	TC	$333.87	$431.82	$884.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $760.00 / $834.30 / $1,399.11	Professional		$760.00	$834.30	$1,399.11
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $203.75 / $220.05 / $366.54	Professional	26	$203.75	$220.05	$366.54
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $556.25 / $614.25 / $1,032.57	Professional	TC	$556.25	$614.25	$1,032.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $284.70 / $772.50 / $1,323.00	Professional		$284.70	$772.50	$1,323.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $177.81 / $246.00 / $366.54	Professional	26	$177.81	$246.00	$366.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $548.79 / $693.00 / $1,032.57	Professional	TC	$548.79	$693.00	$1,032.57
United Facility/Professional Professional Modifier Low / Median / High Price $449.95 / $802.74 / $1,279.03	Professional		$449.95	$802.74	$1,279.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $140.91 / $162.68 / $361.78	Professional	26	$140.91	$162.68	$361.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.73 / $558.72 / $890.22	Professional	TC	$166.73	$558.72	$890.22