Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	26	$144.54	$144.54	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $512.86	Professional		$128.82	$169.82	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $190.55	Professional	26	$44.67	$61.66	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $120.23 / $309.03	Professional	TC	$75.86	$120.23	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $457.09 / $707.95	Professional		$446.68	$457.09	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $151.36 / $169.82	Professional	26	$91.20	$151.36	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $302.00 / $331.13	Professional	TC	$269.15	$302.00	$331.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $380.19 / $602.56	Professional		$245.47	$380.19	$602.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $134.90 / $331.13	Professional	26	$87.10	$134.90	$331.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $234.42 / $331.13	Professional	TC	$165.96	$234.42	$331.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $537.03 / $912.01	Professional		$501.19	$537.03	$912.01
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $181.97 / $309.03	Professional	26	$165.96	$181.97	$309.03
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $363.08 / $602.56	Professional	TC	$331.13	$363.08	$602.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $331.13 / $446.68	Professional		$194.98	$331.13	$446.68
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $91.20 / $169.82	Professional	26	$38.02	$91.20	$169.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $257.04 / $302.00	Professional	TC	$89.13	$257.04	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $524.81 / $1,148.15	Professional		$295.12	$524.81	$1,148.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $204.17 / $446.68	Professional	26	$114.82	$204.17	$446.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $323.59 / $707.95	Professional	TC	$218.78	$323.59	$707.95