Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.52 / $272.80 / $272.80	Professional		$120.52	$272.80	$272.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.12 / $124.76 / $323.39	Professional	26	$55.12	$124.76	$323.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.40 / $148.04 / $148.04	Professional	TC	$65.40	$148.04	$148.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.65 / $139.65 / $139.65	Professional		$139.65	$139.65	$139.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.45 / $79.45 / $79.45	Professional	26	$79.45	$79.45	$79.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.20 / $60.20 / $60.20	Professional	TC	$60.20	$60.20	$60.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.50 / $168.26 / $355.25	Professional		$100.50	$168.26	$355.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.13 / $76.13 / $76.13	Professional	26	$76.13	$76.13	$76.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $92.13 / $92.13 / $92.13	Professional	TC	$92.13	$92.13	$92.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.98 / $253.75 / $371.49	Professional		$82.98	$253.75	$371.49
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.25 / $100.00 / $146.40	Professional	26	$37.25	$100.00	$146.40
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.74 / $153.75 / $225.09	Professional	TC	$45.74	$153.75	$225.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $139.65 / $255.00 / $360.75	Professional		$139.65	$255.00	$360.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $79.45 / $100.00 / $151.69	Professional	26	$79.45	$100.00	$151.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $60.20 / $155.00 / $209.05	Professional	TC	$60.20	$155.00	$209.05
United Facility/Professional Professional Modifier Low / Median / High Price $252.15 / $252.15 / $252.15	Professional		$252.15	$252.15	$252.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $119.49 / $119.49 / $119.49	Professional	26	$119.49	$119.49	$119.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.66 / $132.66 / $132.66	Professional	TC	$132.66	$132.66	$132.66