Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.18 / $306.22 / $306.22	Facility	26	$172.18	$306.22	$306.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $274.70 / $338.16 / $670.11	Professional		$274.70	$338.16	$670.11
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 $224.62 / $279.66 / $425.13	Professional	TC	$224.62	$279.66	$425.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.13 / $616.63 / $825.00	Professional		$254.13	$616.63	$825.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.42 / $188.96 / $247.50	Professional	26	$82.42	$188.96	$247.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.71 / $427.66 / $577.50	Professional	TC	$171.71	$427.66	$577.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $410.00 / $492.00 / $1,079.21	Professional		$410.00	$492.00	$1,079.21
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 $257.94 / $333.81 / $679.64	Professional	TC	$257.94	$333.81	$679.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $633.75 / $795.00 / $1,222.88	Professional		$633.75	$795.00	$1,222.88
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 $430.00 / $587.50 / $851.54	Professional	TC	$430.00	$587.50	$851.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.36 / $667.00 / $1,218.08	Professional		$239.36	$667.00	$1,218.08
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 $437.50 / $577.50 / $946.00	Professional	TC	$437.50	$577.50	$946.00
United Facility/Professional Professional Modifier Low / Median / High Price $445.07 / $587.25 / $1,201.22	Professional		$445.07	$587.25	$1,201.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $244.02 / $388.81	Professional	26	$79.00	$244.02	$388.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $304.14 / $460.68 / $840.06	Professional	TC	$304.14	$460.68	$840.06