Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $190.55 / $190.55	Facility	26	$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $831.76	Professional		$128.82	$162.18	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $74.13 / $275.42	Professional	26	$53.70	$74.13	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $87.10 / $269.15	Professional	TC	$67.61	$87.10	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $416.87	Professional		$398.11	$398.11	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $194.98 / $213.80	Professional	26	$194.98	$194.98	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $186.21 / $223.87	Professional	TC	$186.21	$186.21	$223.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $331.13 / $501.19	Professional		$154.88	$331.13	$501.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $181.97 / $1,258.93	Professional	26	$64.57	$181.97	$1,258.93
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $165.96 / $213.80	Professional	TC	$104.71	$165.96	$213.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $512.86 / $1,122.02	Professional		$467.74	$512.86	$1,122.02
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $245.47 / $524.81	Professional	26	$223.87	$245.47	$524.81
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $263.03 / $588.84	Professional	TC	$245.47	$263.03	$588.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $263.03 / $416.87	Professional		$120.23	$263.03	$416.87
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $81.28 / $213.80	Professional	26	$57.54	$81.28	$213.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $91.20 / $223.87	Professional	TC	$64.57	$91.20	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $478.63 / $1,819.70	Professional		$239.88	$478.63	$1,819.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $257.04 / $977.24	Professional	26	$83.18	$257.04	$977.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $223.87 / $870.96	Professional	TC	$151.36	$223.87	$870.96