Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.77 / $132.77 / $150.55	Facility	26	$132.77	$132.77	$150.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $133.60 / $423.52	Professional		$109.14	$133.60	$423.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $34.93 / $146.22	Professional	26	$29.91	$34.93	$146.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $98.67 / $277.27	Professional	TC	$79.23	$98.67	$277.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.73 / $351.62 / $512.13	Professional		$204.73	$351.62	$512.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.77 / $105.70 / $158.07	Professional	26	$63.77	$105.70	$158.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.94 / $245.92 / $366.15	Professional	TC	$140.94	$245.92	$366.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $330.75 / $396.90 / $874.45	Professional		$330.75	$396.90	$874.45
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.90 / $125.15 / $364.98	Professional	26	$101.90	$125.15	$364.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $217.36 / $274.62 / $668.46	Professional	TC	$217.36	$274.62	$668.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $480.00 / $562.95 / $871.65	Professional		$480.00	$562.95	$871.65
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $122.50 / $170.10 / $246.27	Professional	26	$122.50	$170.10	$246.27
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $353.75 / $392.85 / $587.48	Professional	TC	$353.75	$392.85	$587.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $182.40 / $480.00 / $830.98	Professional		$182.40	$480.00	$830.98
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $99.54 / $192.00 / $246.27	Professional	26	$99.54	$192.00	$246.27
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $263.87 / $393.00 / $591.82	Professional	TC	$263.87	$393.00	$591.82
United Facility/Professional Professional Modifier Low / Median / High Price $156.72 / $337.56 / $725.75	Professional		$156.72	$337.56	$725.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.70 / $131.58 / $271.89	Professional	26	$46.70	$131.58	$271.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.73 / $312.00 / $530.66	Professional	TC	$116.73	$312.00	$530.66