Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.71 / $335.64 / $417.81	Facility	26	$188.71	$335.64	$417.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $303.77 / $373.96 / $972.45	Professional		$303.77	$373.96	$972.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $67.76 / $268.52	Professional	26	$54.86	$67.76	$268.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $248.90 / $309.89 / $639.45	Professional	TC	$248.90	$309.89	$639.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $351.32 / $784.00 / $885.27	Professional		$351.32	$784.00	$885.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.76 / $207.94 / $247.50	Professional	26	$90.76	$207.94	$247.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $260.56 / $551.60 / $677.34	Professional	TC	$260.56	$551.60	$677.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $562.03 / $681.21 / $1,485.72	Professional		$562.03	$681.21	$1,485.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.75 / $177.41 / $438.13	Professional	26	$144.75	$177.41	$438.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $392.50 / $507.51 / $1,047.58	Professional	TC	$392.50	$507.51	$1,047.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $840.00 / $969.30 / $1,555.56	Professional		$840.00	$969.30	$1,555.56
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $223.75 / $241.65 / $404.54	Professional	26	$223.75	$241.65	$404.54
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $613.75 / $727.65 / $1,151.03	Professional	TC	$613.75	$727.65	$1,151.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $329.53 / $847.60 / $1,433.92	Professional		$329.53	$847.60	$1,433.92
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $195.19 / $271.50 / $404.54	Professional	26	$195.19	$271.50	$404.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $551.60 / $772.50 / $1,123.35	Professional	TC	$551.60	$772.50	$1,123.35
United Facility/Professional Professional Modifier Low / Median / High Price $508.84 / $891.54 / $1,821.28	Professional		$508.84	$891.54	$1,821.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.94 / $267.77 / $428.05	Professional	26	$86.94	$267.77	$428.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $405.12 / $622.89 / $992.47	Professional	TC	$405.12	$622.89	$992.47