Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.02 / $154.02 / $154.02	Facility	26	$154.02	$154.02	$154.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $133.99 / $468.33	Professional		$109.45	$133.99	$468.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $34.93 / $200.25	Professional	26	$29.91	$34.93	$200.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.54 / $99.05 / $298.72	Professional	TC	$79.54	$99.05	$298.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.96 / $426.34 / $562.86	Professional		$225.96	$426.34	$562.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.25 / $105.70 / $182.06	Professional	26	$64.25	$105.70	$182.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $152.86 / $289.08 / $393.89	Professional	TC	$152.86	$289.08	$393.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $365.53 / $438.63 / $968.72	Professional		$365.53	$438.63	$968.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.25 / $144.38 / $421.14	Professional	26	$117.25	$144.38	$421.14
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $235.82 / $297.89 / $723.71	Professional	TC	$235.82	$297.89	$723.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $565.00 / $621.00 / $969.99	Professional		$565.00	$621.00	$969.99
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $122.50 / $195.75 / $284.70	Professional	26	$122.50	$195.75	$284.70
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $383.75 / $445.15 / $652.00	Professional	TC	$383.75	$445.15	$652.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $214.86 / $560.40 / $969.99	Professional		$214.86	$560.40	$969.99
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $105.70 / $220.50 / $282.83	Professional	26	$105.70	$220.50	$282.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $320.64 / $445.00 / $742.29	Professional	TC	$320.64	$445.00	$742.29
United Facility/Professional Professional Modifier Low / Median / High Price $156.63 / $401.23 / $947.52	Professional		$156.63	$401.23	$947.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.05 / $151.53 / $366.12	Professional	26	$53.05	$151.53	$366.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.55 / $289.10 / $581.40	Professional	TC	$139.55	$289.10	$581.40