Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.86 / $165.00 / $248.83	Facility	26	$119.86	$165.00	$248.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.54 / $163.25 / $469.67	Professional		$121.54	$163.25	$469.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $43.29 / $156.31	Professional	26	$34.46	$43.29	$156.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.07 / $103.82 / $243.74	Professional	TC	$87.07	$103.82	$243.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.39 / $345.24 / $447.38	Professional		$189.39	$345.24	$447.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.89 / $120.55 / $142.87	Professional	26	$57.89	$120.55	$142.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.51 / $224.69 / $315.49	Professional	TC	$131.51	$224.69	$315.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $304.88 / $365.85 / $820.94	Professional		$304.88	$365.85	$820.94
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.20 / $112.97 / $330.40	Professional	26	$92.20	$112.97	$330.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $201.63 / $255.21 / $601.77	Professional	TC	$201.63	$255.21	$601.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $471.25 / $546.65 / $844.83	Professional		$471.25	$546.65	$844.83
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $142.50 / $153.90 / $259.26	Professional	26	$142.50	$153.90	$259.26
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $326.25 / $355.05 / $585.57	Professional	TC	$326.25	$355.05	$585.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $174.94 / $451.20 / $844.83	Professional		$174.94	$451.20	$844.83
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $111.00 / $174.00 / $259.26	Professional	26	$111.00	$174.00	$259.26
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $263.87 / $393.00 / $594.74	Professional	TC	$263.87	$393.00	$594.74
United Facility/Professional Professional Modifier Low / Median / High Price $205.42 / $325.38 / $514.23	Professional		$205.42	$325.38	$514.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.86 / $114.31 / $211.90	Professional	26	$41.86	$114.31	$211.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.61 / $219.60 / $335.57	Professional	TC	$140.61	$219.60	$335.57