Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $151.36 / $218.78	Professional		$138.04	$151.36	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $112.20 / $173.78	Professional	26	$77.62	$112.20	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $46.77 / $61.66	Professional	TC	$34.67	$46.77	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	26	$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $50.12 / $50.12	Professional	TC	$50.12	$50.12	$50.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $302.00 / $676.08	Professional		$83.18	$302.00	$676.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $169.82 / $245.47	Professional	26	$63.10	$169.82	$245.47
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $67.61 / $75.86	Professional	TC	$19.05	$67.61	$75.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $489.78 / $630.96	Professional		$194.98	$489.78	$630.96
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $380.19 / $467.74	Professional	26	$114.82	$380.19	$467.74
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $117.49 / $165.96	Professional	TC	$77.62	$117.49	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	26	$91.20	$91.20	$91.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $50.12 / $50.12	Professional	TC	$50.12	$50.12	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $309.03 / $467.74	Professional		$117.49	$309.03	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $251.19 / $380.19	Professional	26	$91.20	$251.19	$380.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $58.88 / $89.13	Professional	TC	$26.92	$58.88	$89.13