Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.80 / $338.80 / $493.74	Professional		$338.80	$338.80	$493.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.31 / $64.31 / $77.03	Professional	26	$64.31	$64.31	$77.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.49 / $274.49 / $416.72	Professional	TC	$274.49	$274.49	$416.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.45 / $204.55 / $415.46	Professional		$164.45	$204.55	$415.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $58.83 / $66.33	Professional	26	$28.47	$58.83	$66.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.99 / $145.72 / $350.47	Professional	TC	$135.99	$145.72	$350.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $263.36 / $319.26 / $714.34	Professional		$263.36	$319.26	$714.34
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.28 / $54.95 / $161.91	Professional	26	$45.28	$54.95	$161.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.90 / $264.93 / $682.31	Professional	TC	$204.90	$264.93	$682.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $358.75 / $477.90 / $678.60	Professional		$358.75	$477.90	$678.60
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.00 / $76.95 / $120.69	Professional	26	$65.00	$76.95	$120.69
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $293.75 / $400.95 / $563.22	Professional	TC	$293.75	$400.95	$563.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $153.94 / $358.75 / $623.55	Professional		$153.94	$358.75	$623.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.00 / $81.00 / $120.69	Professional	26	$56.00	$81.00	$120.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $229.89 / $378.00 / $562.36	Professional	TC	$229.89	$378.00	$562.36
United Facility/Professional Professional Modifier Low / Median / High Price $95.94 / $256.08 / $605.83	Professional		$95.94	$256.08	$605.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.47 / $55.21 / $133.38	Professional	26	$25.47	$55.21	$133.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.94 / $253.44 / $465.85	Professional	TC	$90.94	$253.44	$465.85