Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.69 / $117.98 / $230.48	Facility	26	$85.69	$117.98	$230.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.09 / $123.92 / $246.51	Professional		$69.09	$123.92	$246.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $31.41 / $108.47	Professional	26	$25.26	$31.41	$108.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.67 / $88.11 / $118.06	Professional	TC	$37.67	$88.11	$118.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.56 / $109.20 / $203.52	Professional		$77.56	$109.20	$203.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.94 / $52.31 / $101.47	Professional	26	$21.94	$52.31	$101.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.07 / $50.12 / $109.23	Professional	TC	$42.07	$50.12	$109.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $147.18 / $176.61 / $356.93	Professional		$147.18	$176.61	$356.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.30 / $79.56 / $182.56	Professional	26	$66.30	$79.56	$182.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.06 / $97.05 / $174.38	Professional	TC	$80.06	$97.05	$174.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.24 / $247.50 / $371.01	Professional		$149.24	$247.50	$371.01
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.50 / $118.90 / $164.00	Professional	26	$102.50	$118.90	$164.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.90 / $135.00 / $183.00	Professional	TC	$118.90	$135.00	$183.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.62 / $185.79 / $332.00	Professional		$74.62	$185.79	$332.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $52.31 / $123.00 / $186.14	Professional	26	$52.31	$123.00	$186.14
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $77.05 / $126.00 / $197.54	Professional	TC	$77.05	$126.00	$197.54
United Facility/Professional Professional Modifier Low / Median / High Price $104.46 / $185.78 / $309.89	Professional		$104.46	$185.78	$309.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.27 / $101.48 / $169.27	Professional	26	$39.27	$101.48	$169.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $99.69 / $140.62	Professional	TC	$66.45	$99.69	$140.62