Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $169.82	Professional		$91.20	$117.49	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $79.43 / $120.23	Professional	26	$54.95	$79.43	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $39.81 / $51.29	Professional	TC	$36.31	$39.81	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	26	$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $23.44 / $23.44	Professional	TC	$23.44	$23.44	$23.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $239.88 / $416.87	Professional		$114.82	$239.88	$416.87
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $165.96 / $436.52	Professional	26	$74.13	$165.96	$436.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $70.79 / $75.86	Professional	TC	$38.90	$70.79	$75.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $416.87 / $501.19	Professional		$138.04	$416.87	$501.19
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $269.15 / $331.13	Professional	26	$83.18	$269.15	$331.13
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $144.54 / $173.78	Professional	TC	$53.70	$144.54	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	26	$81.28	$81.28	$81.28
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $23.44 / $23.44	Professional	TC	$23.44	$23.44	$23.44
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $239.88 / $354.81	Professional		$91.20	$239.88	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $177.83 / $269.15	Professional	26	$64.57	$177.83	$269.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $58.88 / $89.13	Professional	TC	$26.92	$58.88	$89.13