Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.71 / $203.33 / $322.82	Facility	26	$147.71	$203.33	$322.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.33 / $182.14 / $612.38	Professional		$154.33	$182.14	$612.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $53.55 / $193.31	Professional	26	$42.89	$53.55	$193.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.43 / $132.85 / $310.83	Professional	TC	$111.43	$132.85	$310.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.89 / $437.22 / $565.45	Professional		$237.89	$437.22	$565.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $149.69 / $175.64	Professional	26	$70.64	$149.69	$175.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.25 / $287.52 / $402.33	Professional	TC	$167.25	$287.52	$402.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $384.13 / $460.95 / $996.00	Professional		$384.13	$460.95	$996.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.23 / $139.21 / $406.12	Professional	26	$113.23	$139.21	$406.12
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.16 / $325.08 / $770.97	Professional	TC	$251.16	$325.08	$770.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $593.75 / $642.60 / $1,063.85	Professional		$593.75	$642.60	$1,063.85
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $175.00 / $189.00 / $317.37	Professional	26	$175.00	$189.00	$317.37
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $417.50 / $453.60 / $746.49	Professional	TC	$417.50	$453.60	$746.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $220.91 / $568.79 / $1,063.85	Professional		$220.91	$568.79	$1,063.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $138.00 / $213.00 / $320.07	Professional	26	$138.00	$213.00	$320.07
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $336.49 / $501.00 / $758.18	Professional	TC	$336.49	$501.00	$758.18
United Facility/Professional Professional Modifier Low / Median / High Price $253.09 / $409.70 / $622.14	Professional		$253.09	$409.70	$622.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.22 / $140.82 / $220.38	Professional	26	$73.22	$140.82	$220.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.56 / $273.94 / $428.72	Professional	TC	$192.56	$273.94	$428.72