Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Facility	26	$89.13	$89.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $138.04 / $380.19	Professional		$77.62	$138.04	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $37.15 / $93.33	Professional	26	$21.88	$37.15	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $109.65 / $288.40	Professional	TC	$56.23	$109.65	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $457.09	Professional		$269.15	$288.40	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $89.13 / $102.33	Professional	26	$52.48	$89.13	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $263.03 / $363.08	Professional	TC	$199.53	$263.03	$363.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $354.81 / $537.03	Professional		$154.88	$354.81	$537.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $134.90	Professional	26	$57.54	$85.11	$134.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $281.84 / $457.09	Professional	TC	$204.17	$281.84	$457.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $741.31	Professional		$371.54	$524.81	$741.31
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $112.20 / $186.21	Professional	26	$104.71	$112.20	$186.21
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $407.38 / $575.44	Professional	TC	$269.15	$407.38	$575.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $269.15 / $363.08	Professional		$112.20	$269.15	$363.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $52.48 / $102.33	Professional	26	$23.44	$52.48	$102.33
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $302.00	Professional	TC	$77.62	$112.20	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $630.96	Professional		$245.47	$302.00	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $85.11 / $194.98	Professional	26	$70.79	$85.11	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $218.78 / $457.09	Professional	TC	$165.96	$218.78	$457.09