Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.59 / $397.45 / $397.45	Professional		$175.59	$397.45	$397.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.88 / $278.14 / $278.14	Professional	26	$122.88	$278.14	$278.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.72 / $119.32 / $119.32	Professional	TC	$52.72	$119.32	$119.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.06 / $105.06 / $105.06	Professional		$105.06	$105.06	$105.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.68 / $81.68 / $81.68	Professional	26	$81.68	$81.68	$81.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $23.38 / $23.38	Professional	TC	$23.38	$23.38	$23.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $239.19 / $239.19 / $477.75	Professional		$239.19	$239.19	$477.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $168.86 / $168.86 / $168.86	Professional	26	$168.86	$168.86	$168.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.33 / $70.33 / $70.33	Professional	TC	$70.33	$70.33	$70.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.68 / $341.25 / $499.59	Professional		$137.68	$341.25	$499.59
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.93 / $223.75 / $327.57	Professional	26	$83.93	$223.75	$327.57
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.75 / $117.50 / $172.02	Professional	TC	$53.75	$117.50	$172.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $105.06 / $342.50 / $471.75	Professional		$105.06	$342.50	$471.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $81.68 / $222.50 / $342.25	Professional	26	$81.68	$222.50	$342.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $120.00 / $145.50	Professional	TC	$23.38	$120.00	$145.50
United Facility/Professional Professional Modifier Low / Median / High Price $356.82 / $356.82 / $356.82	Professional		$356.82	$356.82	$356.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $267.72 / $267.72 / $267.72	Professional	26	$267.72	$267.72	$267.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.10 / $89.10 / $89.10	Professional	TC	$89.10	$89.10	$89.10