Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $204.60 / $204.60 / $204.60	Facility	26	$204.60	$204.60	$204.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.27 / $238.19 / $392.63	Professional		$194.27	$238.19	$392.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $58.13 / $225.31	Professional	26	$49.65	$58.13	$225.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.61 / $167.32 / $180.05	Professional	TC	$144.61	$167.32	$180.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.13 / $428.02 / $443.43	Professional		$196.13	$428.02	$443.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.73 / $171.91 / $242.94	Professional	26	$101.73	$171.91	$242.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.84 / $194.27 / $256.11	Professional	TC	$87.84	$194.27	$256.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $304.05 / $368.78 / $827.15	Professional		$304.05	$368.78	$827.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $161.72 / $194.07 / $477.57	Professional	26	$161.72	$194.07	$477.57
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $135.04 / $170.79 / $413.08	Professional	TC	$135.04	$170.79	$413.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $466.25 / $511.65 / $876.12	Professional		$466.25	$511.65	$876.12
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $205.40 / $270.00 / $397.50	Professional	26	$205.40	$270.00	$397.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $220.00 / $273.00 / $458.00	Professional	TC	$220.00	$273.00	$458.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $177.18 / $453.60 / $867.14	Professional		$177.18	$453.60	$867.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $171.91 / $298.50 / $397.50	Professional	26	$171.91	$298.50	$397.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $216.00 / $289.50 / $458.00	Professional	TC	$216.00	$289.50	$458.00
United Facility/Professional Professional Modifier Low / Median / High Price $339.06 / $437.20 / $932.42	Professional		$339.06	$437.20	$932.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.45 / $202.22 / $426.75	Professional	26	$78.45	$202.22	$426.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.63 / $233.10 / $554.00	Professional	TC	$154.63	$233.10	$554.00