Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.39 / $112.39 / $112.39	Facility	26	$112.39	$112.39	$112.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.34 / $188.61 / $438.85	Professional		$137.34	$188.61	$438.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.57 / $40.60 / $133.02	Professional	26	$32.57	$40.60	$133.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.76 / $148.01 / $315.07	Professional	TC	$104.76	$148.01	$315.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.41 / $241.76 / $468.15	Professional		$144.41	$241.76	$468.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.71 / $68.81 / $134.08	Professional	26	$28.71	$68.81	$134.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.32 / $165.26 / $334.07	Professional	TC	$103.32	$165.26	$334.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $349.40 / $425.04 / $837.90	Professional		$349.40	$425.04	$837.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.53 / $103.83 / $238.92	Professional	26	$86.53	$103.83	$238.92
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $267.68 / $321.20 / $598.98	Professional	TC	$267.68	$321.20	$598.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $547.50 / $635.10 / $894.00	Professional		$547.50	$635.10	$894.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $133.75 / $155.15 / $216.00	Professional	26	$133.75	$155.15	$216.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $412.50 / $479.95 / $678.00	Professional	TC	$412.50	$479.95	$678.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $184.24 / $456.37 / $882.00	Professional		$184.24	$456.37	$882.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $70.23 / $162.00 / $243.62	Professional	26	$70.23	$162.00	$243.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $237.14 / $498.00 / $774.62	Professional	TC	$237.14	$498.00	$774.62
United Facility/Professional Professional Modifier Low / Median / High Price $177.74 / $468.15 / $780.91	Professional		$177.74	$468.15	$780.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.96 / $107.26 / $214.52	Professional	26	$36.96	$107.26	$214.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.82 / $337.99 / $567.92	Professional	TC	$130.82	$337.99	$567.92