Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $123.03 / $154.88	Facility	26	$87.10	$123.03	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $398.11	Professional		$74.13	$134.90	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $41.69 / $114.82	Professional	26	$28.18	$41.69	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $87.10 / $281.84	Professional	TC	$39.81	$87.10	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $371.54 / $707.95	Professional		$302.00	$371.54	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $95.50 / $208.93	Professional	26	$53.70	$95.50	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $275.42 / $489.78	Professional	TC	$213.80	$275.42	$489.78
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $154.88 / $162.18	Facility	26	$100.00	$154.88	$162.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $275.42 / $524.81	Professional		$138.04	$275.42	$524.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $81.28 / $158.49	Professional	26	$43.65	$81.28	$158.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $194.98 / $354.81	Professional	TC	$97.72	$194.98	$354.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $416.87 / $660.69	Professional		$363.08	$416.87	$660.69
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $109.65 / $181.97	Professional	26	$102.33	$109.65	$181.97
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $302.00 / $467.74	Professional	TC	$263.03	$302.00	$467.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $257.04 / $316.23	Professional		$138.04	$257.04	$316.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $87.10 / $208.93	Professional	26	$23.44	$87.10	$208.93
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $213.80 / $489.78	Professional	TC	$69.18	$213.80	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $371.54 / $812.83	Professional		$134.90	$371.54	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $263.03	Professional	26	$70.79	$120.23	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $251.19 / $549.54	Professional	TC	$169.82	$251.19	$549.54