Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $194.98 / $194.98	Facility	26	$194.98	$194.98	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $851.14	Professional		$169.82	$275.42	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $223.87	Professional	26	$51.29	$72.44	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $269.15 / $588.84	Professional	TC	$120.23	$269.15	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $707.95	Professional		$602.56	$602.56	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $190.55 / $218.78	Professional	26	$190.55	$190.55	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $416.87 / $478.63	Professional	TC	$416.87	$416.87	$478.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $549.54 / $707.95	Professional		$436.52	$549.54	$707.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $151.36 / $194.98	Professional	26	$85.11	$151.36	$194.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $407.38 / $524.81	Professional	TC	$389.05	$407.38	$524.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $891.25 / $1,202.26	Professional		$812.83	$891.25	$1,202.26
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $245.47 / $331.13	Professional	26	$223.87	$245.47	$331.13
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $645.65 / $870.96	Professional	TC	$588.84	$645.65	$870.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $446.68 / $707.95	Professional		$213.80	$446.68	$707.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $218.78	Professional	26	$58.88	$85.11	$218.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $223.87 / $478.63	Professional	TC	$154.88	$223.87	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $741.31 / $2,818.38	Professional		$549.54	$741.31	$2,818.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $177.83 / $891.25	Professional	26	$81.28	$177.83	$891.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $457.09 / $1,905.46	Professional	TC	$371.54	$457.09	$1,905.46