Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.86 / $300.73 / $300.73	Professional		$132.86	$300.73	$300.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.16 / $115.80 / $115.80	Professional	26	$51.16	$115.80	$115.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.70 / $184.93 / $184.93	Professional	TC	$81.70	$184.93	$184.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.48 / $59.48 / $59.48	Professional		$59.48	$59.48	$59.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.65 / $33.65 / $33.65	Professional	26	$33.65	$33.65	$33.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.81 / $25.81 / $25.81	Professional	TC	$25.81	$25.81	$25.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $201.50 / $201.50 / $437.50	Professional		$201.50	$201.50	$437.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.61 / $70.61 / $70.61	Professional	26	$70.61	$70.61	$70.61
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $130.88 / $130.88 / $130.88	Professional	TC	$130.88	$130.88	$130.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.87 / $309.00 / $457.50	Professional		$84.87	$309.00	$457.50
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $93.75 / $137.25	Professional	26	$34.89	$93.75	$137.25
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.98 / $198.00 / $320.25	Professional	TC	$49.98	$198.00	$320.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $59.48 / $298.75 / $381.10	Professional		$59.48	$298.75	$381.10
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.65 / $92.50 / $140.60	Professional	26	$33.65	$92.50	$140.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.81 / $198.00 / $240.50	Professional	TC	$25.81	$198.00	$240.50
United Facility/Professional Professional Modifier Low / Median / High Price $262.98 / $262.98 / $262.98	Professional		$262.98	$262.98	$262.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.97 / $110.97 / $110.97	Professional	26	$110.97	$110.97	$110.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.96 / $93.96 / $152.01	Professional	TC	$93.96	$93.96	$152.01