Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $151.36	Facility	26	$134.90	$134.90	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $426.58	Professional		$104.71	$158.49	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $52.48 / $144.54	Professional	26	$30.20	$52.48	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $114.82 / $275.42	Professional	TC	$72.44	$114.82	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $354.81 / $501.19	Professional		$281.84	$354.81	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $104.71 / $158.49	Professional	26	$64.57	$104.71	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $263.03 / $354.81	Professional	TC	$245.47	$263.03	$354.81
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	26	$151.36	$151.36	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $363.08 / $562.34	Professional		$158.49	$363.08	$562.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $125.89 / $204.17	Professional	26	$54.95	$125.89	$204.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $251.19 / $354.81	Professional	TC	$138.04	$251.19	$354.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $831.76	Professional		$467.74	$562.34	$831.76
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $169.82 / $245.47	Professional	26	$123.03	$169.82	$245.47
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $389.05 / $588.84	Professional	TC	$338.84	$389.05	$588.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $281.84 / $389.05	Professional		$128.82	$281.84	$389.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $64.57 / $158.49	Professional	26	$32.36	$64.57	$158.49
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $134.90 / $281.84	Professional	TC	$87.10	$134.90	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $354.81 / $724.44	Professional		$302.00	$354.81	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $131.83 / $263.03	Professional	26	$97.72	$131.83	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $257.04 / $457.09	Professional	TC	$208.93	$257.04	$457.09