Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $138.04 / $138.04	Professional		$57.54	$138.04	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $48.98 / $60.26	Professional	26	$25.70	$48.98	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $91.20 / $91.20	Professional	TC	$31.62	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	26	$33.88	$33.88	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Professional	TC	$30.20	$30.20	$30.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $436.52	Professional		$204.17	$204.17	$436.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $234.42	Professional	26	$70.79	$70.79	$234.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $134.90 / $204.17	Professional	TC	$134.90	$134.90	$204.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $309.03 / $457.09	Professional		$77.62	$309.03	$457.09
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $109.65 / $134.90	Professional	26	$33.11	$109.65	$134.90
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $199.53 / $323.59	Professional	TC	$43.65	$199.53	$323.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Professional		$64.57	$64.57	$64.57
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	26	$33.88	$33.88	$33.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Professional	TC	$30.20	$30.20	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $169.82 / $251.19	Professional		$69.18	$169.82	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $72.44 / $109.65	Professional	26	$26.30	$72.44	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $95.50 / $144.54	Professional	TC	$43.65	$95.50	$144.54