Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.55 / $88.55 / $88.55	Facility	26	$88.55	$88.55	$88.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.26 / $129.37 / $386.96	Professional		$98.26	$129.37	$386.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.35 / $31.78 / $115.98	Professional	26	$26.35	$31.78	$115.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.89 / $97.59 / $212.05	Professional	TC	$71.89	$97.59	$212.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.80 / $166.51 / $325.33	Professional		$111.80	$166.51	$325.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.95 / $53.85 / $103.83	Professional	26	$32.95	$53.85	$103.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.84 / $116.12 / $221.50	Professional	TC	$78.84	$116.12	$221.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $253.81 / $307.62 / $597.16	Professional		$253.81	$307.62	$597.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.73 / $82.47 / $188.62	Professional	26	$68.73	$82.47	$188.62
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $185.84 / $225.12 / $408.55	Professional	TC	$185.84	$225.12	$408.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.00 / $456.00 / $608.00	Professional		$380.00	$456.00	$608.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.25 / $123.25 / $170.00	Professional	26	$106.25	$123.25	$170.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $273.75 / $328.50 / $438.00	Professional	TC	$273.75	$328.50	$438.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.91 / $323.17 / $608.00	Professional		$127.91	$323.17	$608.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $60.35 / $126.00 / $192.95	Professional	26	$60.35	$126.00	$192.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $155.49 / $330.00 / $500.42	Professional	TC	$155.49	$330.00	$500.42
United Facility/Professional Professional Modifier Low / Median / High Price $112.09 / $325.33 / $553.04	Professional		$112.09	$325.33	$553.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.32 / $124.59 / $176.50	Professional	26	$42.32	$124.59	$176.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.69 / $265.80 / $376.55	Professional	TC	$98.69	$265.80	$376.55