Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.71 / $123.48 / $147.03	Facility	26	$89.71	$123.48	$147.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $100.19 / $296.86	Professional		$81.68	$100.19	$296.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $37.47 / $123.48	Professional	26	$19.89	$37.47	$123.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.79 / $76.95 / $198.07	Professional	TC	$61.79	$76.95	$198.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.41 / $248.91 / $357.83	Professional		$144.41	$248.91	$357.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.75 / $70.92 / $105.18	Professional	26	$42.75	$70.92	$105.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.24 / $177.99 / $260.00	Professional	TC	$101.24	$177.99	$260.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $232.90 / $279.48 / $610.23	Professional		$232.90	$279.48	$610.23
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.73 / $84.11 / $243.69	Professional	26	$68.73	$84.11	$243.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $152.26 / $196.98 / $477.49	Professional	TC	$152.26	$196.98	$477.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $341.25 / $394.20 / $605.69	Professional		$341.25	$394.20	$605.69
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.25 / $123.25 / $172.08	Professional	26	$106.25	$123.25	$172.08
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $221.25 / $280.80 / $417.42	Professional	TC	$221.25	$280.80	$417.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $129.68 / $341.25 / $581.67	Professional		$129.68	$341.25	$581.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $67.15 / $127.50 / $172.08	Professional	26	$67.15	$127.50	$172.08
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $187.21 / $279.00 / $420.44	Professional	TC	$187.21	$279.00	$420.44
United Facility/Professional Professional Modifier Low / Median / High Price $101.47 / $256.89 / $584.54	Professional		$101.47	$256.89	$584.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.30 / $97.32 / $180.90	Professional	26	$31.30	$97.32	$180.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.02 / $149.78 / $322.02	Professional	TC	$76.02	$149.78	$322.02