Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.16 / $147.41 / $147.41	Facility	26	$73.16	$147.41	$147.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.92 / $86.17 / $147.76	Professional		$43.92	$86.17	$147.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.48 / $27.42 / $126.00	Professional	26	$23.48	$27.42	$126.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.24 / $47.17 / $100.74	Professional	TC	$41.24	$47.17	$100.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.44 / $149.44 / $217.71	Professional		$149.44	$149.44	$217.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.28 / $83.28 / $84.72	Professional	26	$83.28	$83.28	$84.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.16 / $66.16 / $132.99	Professional	TC	$66.16	$66.16	$132.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.78 / $119.37 / $215.25	Professional		$70.78	$119.37	$215.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.25 / $58.23 / $74.98	Professional	26	$41.25	$58.23	$74.98
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.25 / $49.50 / $53.13	Professional	TC	$41.25	$49.50	$53.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.75 / $178.35 / $454.45	Professional		$153.75	$178.35	$454.45
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $95.85 / $207.40	Professional	26	$85.00	$95.85	$207.40
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.45 / $73.95 / $250.00	Professional	TC	$63.45	$73.95	$250.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $110.63 / $186.25 / $420.00	Professional		$110.63	$186.25	$420.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $84.72 / $102.00 / $207.40	Professional	26	$84.72	$102.00	$207.40
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $58.75 / $101.25 / $250.00	Professional	TC	$58.75	$101.25	$250.00
United Facility/Professional Professional Modifier Low / Median / High Price $111.95 / $146.63 / $684.15	Professional		$111.95	$146.63	$684.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.08 / $99.93 / $381.22	Professional	26	$36.08	$99.93	$381.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.94 / $79.41 / $302.93	Professional	TC	$52.94	$79.41	$302.93