Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.28 / $430.71 / $430.71	Professional		$190.28	$430.71	$430.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.68 / $277.68 / $1,323.00	Professional	26	$80.68	$277.68	$1,323.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $153.03 / $153.03	Professional	TC	$67.61	$153.03	$153.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.39 / $105.39 / $105.39	Professional		$105.39	$105.39	$105.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.37 / $80.37 / $80.37	Professional	26	$80.37	$80.37	$80.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.02 / $25.02 / $25.02	Professional	TC	$25.02	$25.02	$25.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $260.69 / $528.50	Professional		$102.00	$260.69	$528.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $169.31 / $169.31 / $169.31	Professional	26	$169.31	$169.31	$169.31
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.38 / $91.38 / $91.38	Professional	TC	$91.38	$91.38	$91.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.13 / $377.50 / $552.66	Professional		$130.13	$377.50	$552.66
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.51 / $225.00 / $329.40	Professional	26	$82.51	$225.00	$329.40
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.62 / $152.50 / $223.26	Professional	TC	$47.62	$152.50	$223.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $105.39 / $378.75 / $512.45	Professional		$105.39	$378.75	$512.45
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $80.37 / $223.75 / $342.25	Professional	26	$80.37	$223.75	$342.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.02 / $155.00 / $181.50	Professional	TC	$25.02	$155.00	$181.50
United Facility/Professional Professional Modifier Low / Median / High Price $384.24 / $384.24 / $384.24	Professional		$384.24	$384.24	$384.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $267.33 / $267.33 / $267.33	Professional	26	$267.33	$267.33	$267.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.51 / $77.94 / $116.91	Professional	TC	$65.51	$77.94	$116.91