Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $176.47 / $323.42 / $417.31	Facility	26	$176.47	$323.42	$417.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.90 / $274.81 / $597.64	Professional		$223.90	$274.81	$597.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $59.87 / $251.11	Professional	26	$51.28	$59.87	$251.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.62 / $214.94 / $307.68	Professional	TC	$172.62	$214.94	$307.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.96 / $487.60 / $700.00	Professional		$207.96	$487.60	$700.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.38 / $182.24 / $210.00	Professional	26	$84.38	$182.24	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.58 / $308.25 / $490.00	Professional	TC	$123.58	$308.25	$490.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $335.60 / $408.74 / $901.29	Professional		$335.60	$408.74	$901.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.05 / $165.89 / $409.64	Professional	26	$135.05	$165.89	$409.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.10 / $240.66 / $491.65	Professional	TC	$186.10	$240.66	$491.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $518.75 / $567.00 / $938.70	Professional		$518.75	$567.00	$938.70
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $208.75 / $225.45 / $377.72	Professional	26	$208.75	$225.45	$377.72
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $310.00 / $341.55 / $560.99	Professional	TC	$310.00	$341.55	$560.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $199.91 / $525.00 / $890.40	Professional		$199.91	$525.00	$890.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $170.00 / $253.50 / $377.72	Professional	26	$170.00	$253.50	$377.72
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $307.20 / $376.50 / $560.99	Professional	TC	$307.20	$376.50	$560.99
United Facility/Professional Professional Modifier Low / Median / High Price $369.42 / $557.19 / $1,059.00	Professional		$369.42	$557.19	$1,059.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.98 / $250.80 / $478.00	Professional	26	$80.98	$250.80	$478.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $202.22 / $305.07 / $581.00	Professional	TC	$202.22	$305.07	$581.00