Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $175.31 / $175.31 / $175.31	Facility	26	$175.31	$175.31	$175.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.22 / $197.96 / $522.22	Professional		$162.22	$197.96	$522.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $60.07 / $193.08	Professional	26	$51.54	$60.07	$193.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.68 / $137.88 / $329.14	Professional	TC	$110.68	$137.88	$329.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $476.40 / $476.40 / $547.98	Professional		$476.40	$476.40	$547.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $181.03 / $181.03 / $208.10	Professional	26	$181.03	$181.03	$208.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.37 / $295.37 / $339.89	Professional	TC	$295.37	$295.37	$339.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $241.78 / $511.41 / $922.25	Professional		$241.78	$511.41	$922.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.25 / $161.10 / $172.91	Professional	26	$134.25	$161.10	$172.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $291.93 / $350.31 / $376.00	Professional	TC	$291.93	$350.31	$376.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $636.25 / $708.75 / $964.41	Professional		$636.25	$708.75	$964.41
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $207.50 / $222.75 / $303.77	Professional	26	$207.50	$222.75	$303.77
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $426.25 / $486.00 / $660.63	Professional	TC	$426.25	$486.00	$660.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $241.78 / $656.25 / $1,172.21	Professional		$241.78	$656.25	$1,172.21
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $198.00 / $250.50 / $383.88	Professional	26	$198.00	$250.50	$383.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $339.89 / $508.50 / $788.33	Professional	TC	$339.89	$508.50	$788.33
United Facility/Professional Professional Modifier Low / Median / High Price $293.42 / $438.38 / $657.57	Professional		$293.42	$438.38	$657.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.70 / $166.48 / $249.72	Professional	26	$81.70	$166.48	$249.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.71 / $271.89 / $407.85	Professional	TC	$211.71	$271.89	$407.85