Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.40 / $87.40 / $87.40	Facility	26	$87.40	$87.40	$87.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.79 / $117.41 / $269.16	Professional		$95.79	$117.41	$269.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.26 / $86.27 / $172.91	Professional	TC	$69.26	$86.27	$172.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.00 / $277.02 / $319.31	Professional		$133.00	$277.02	$319.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.30 / $181.39 / $223.82	Professional	TC	$91.30	$181.39	$223.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $213.48 / $256.17 / $561.99	Professional		$213.48	$256.17	$561.99
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $136.13 / $176.61 / $361.24	Professional	TC	$136.13	$176.61	$361.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.00 / $361.80 / $614.63	Professional		$330.00	$361.80	$614.63
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $222.50 / $251.10 / $417.95	Professional	TC	$222.50	$251.10	$417.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $124.64 / $324.00 / $591.82	Professional		$124.64	$324.00	$591.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $188.22 / $280.50 / $417.95	Professional	TC	$188.22	$280.50	$417.95
United Facility/Professional Professional Modifier Low / Median / High Price $113.71 / $245.45 / $611.92	Professional		$113.71	$245.45	$611.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.76 / $203.43 / $372.95	Professional	TC	$125.76	$203.43	$372.95