Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.75 / $500.78 / $718.20	Facility		$84.75	$500.78	$718.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $33.03 / $71.40	Facility	26	$23.99	$33.03	$71.40
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $70.01 / $306.73 / $523.59	Facility	TC	$70.01	$306.73	$523.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $35.82 / $132.62	Professional		$24.92	$35.82	$132.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $11.89 / $45.70	Professional	26	$7.33	$11.89	$45.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $22.52 / $101.18	Professional	TC	$17.57	$22.52	$101.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $386.22 / $386.22 / $386.22	Facility		$386.22	$386.22	$386.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $76.54 / $111.63	Professional		$48.00	$76.54	$111.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $26.52 / $28.30	Professional	26	$11.77	$26.52	$28.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $49.77 / $85.11	Professional	TC	$36.22	$49.77	$85.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.07 / $42.08 / $635.35	Facility		$35.07	$42.08	$635.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $75.40 / $92.19 / $195.25	Professional		$75.40	$92.19	$195.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $22.61 / $66.17	Professional	26	$18.60	$22.61	$66.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.04 / $69.87 / $164.58	Professional	TC	$55.04	$69.87	$164.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.75 / $128.25 / $192.21	Professional		$103.75	$128.25	$192.21
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.75 / $33.35 / $51.41	Professional	26	$28.75	$33.35	$51.41
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.00 / $97.20 / $140.81	Professional	TC	$75.00	$97.20	$140.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.07 / $42.08 / $386.22	Facility		$35.07	$42.08	$386.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.94 / $103.75 / $188.00	Professional		$40.94	$103.75	$188.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $34.50 / $52.21	Professional	26	$25.00	$34.50	$52.21
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $56.09 / $94.50 / $140.81	Professional	TC	$56.09	$94.50	$140.81
United Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $81.62 / $183.91	Professional		$39.26	$81.62	$183.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.94 / $28.30 / $56.91	Professional	26	$11.94	$28.30	$56.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.40 / $52.56 / $125.23	Professional	TC	$30.40	$52.56	$125.23