Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.61 / $306.97 / $306.97	Professional		$135.61	$306.97	$306.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.60 / $114.55 / $120.27	Professional	26	$50.60	$114.55	$120.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.01 / $192.43 / $192.43	Professional	TC	$85.01	$192.43	$192.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.98 / $63.98 / $63.98	Professional		$63.98	$63.98	$63.98
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 $30.32 / $30.32 / $30.32	Professional	TC	$30.32	$30.32	$30.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $203.00 / $203.00 / $441.00	Professional		$203.00	$203.00	$441.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.88 / $69.88 / $69.88	Professional	26	$69.88	$69.88	$69.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.13 / $133.13 / $133.13	Professional	TC	$133.13	$133.13	$133.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.33 / $309.00 / $461.16	Professional		$77.33	$309.00	$461.16
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.47 / $92.50 / $135.41	Professional	26	$33.47	$92.50	$135.41
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.85 / $199.50 / $325.74	Professional	TC	$43.85	$199.50	$325.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.98 / $305.00 / $345.95	Professional		$63.98	$305.00	$345.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.65 / $91.25 / $135.05	Professional	26	$33.65	$91.25	$135.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $199.50 / $213.75	Professional	TC	$30.32	$199.50	$213.75
United Facility/Professional Professional Modifier Low / Median / High Price $253.32 / $253.32 / $253.32	Professional		$253.32	$253.32	$253.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.54 / $108.54 / $108.54	Professional	26	$108.54	$108.54	$108.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.78 / $144.78 / $144.78	Professional	TC	$144.78	$144.78	$144.78