Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $185.32 / $185.32 / $185.32	Facility	26	$185.32	$185.32	$185.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.58 / $399.84 / $1,254.09	Professional		$137.58	$399.84	$1,254.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $107.36 / $426.68	Professional	26	$53.67	$107.36	$426.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.90 / $179.17 / $295.89	Professional	TC	$83.90	$179.17	$295.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $401.30 / $401.30 / $415.25	Professional		$401.30	$401.30	$415.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $193.10 / $193.10 / $213.09	Professional	26	$193.10	$193.10	$213.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.22 / $188.22 / $222.15	Professional	TC	$188.22	$188.22	$222.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $172.90 / $368.76 / $665.00	Professional		$172.90	$368.76	$665.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.18 / $176.61 / $189.56	Professional	26	$147.18	$176.61	$189.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $160.13 / $192.15 / $206.24	Professional	TC	$160.13	$192.15	$206.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $455.00 / $508.95 / $1,110.20	Professional		$455.00	$508.95	$1,110.20
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $215.00 / $243.00 / $524.60	Professional	26	$215.00	$243.00	$524.60
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $240.00 / $265.95 / $585.60	Professional	TC	$240.00	$265.95	$585.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $261.93 / $471.25 / $1,001.00	Professional		$261.93	$471.25	$1,001.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $213.09 / $261.00 / $524.60	Professional	26	$213.09	$261.00	$524.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $222.15 / $280.50 / $585.60	Professional	TC	$222.15	$280.50	$585.60
United Facility/Professional Professional Modifier Low / Median / High Price $238.77 / $481.56 / $1,837.06	Professional		$238.77	$481.56	$1,837.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.24 / $255.72 / $975.53	Professional	26	$82.24	$255.72	$975.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.56 / $225.84 / $861.53	Professional	TC	$150.56	$225.84	$861.53