Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.53 / $241.12 / $241.12	Professional		$106.53	$241.12	$241.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.53 / $168.70 / $168.70	Professional	26	$74.53	$168.70	$168.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.00 / $72.43 / $72.43	Professional	TC	$32.00	$72.43	$72.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.49 / $54.49 / $54.49	Professional		$54.49	$54.49	$54.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.14 / $40.14 / $40.14	Professional	26	$40.14	$40.14	$40.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.35 / $14.35 / $14.35	Professional	TC	$14.35	$14.35	$14.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $146.47 / $146.47 / $292.25	Professional		$146.47	$146.47	$292.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.88 / $102.88 / $102.88	Professional	26	$102.88	$102.88	$102.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.60 / $43.60 / $43.60	Professional	TC	$43.60	$43.60	$43.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $208.75 / $305.61	Professional		$85.81	$208.75	$305.61
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.87 / $136.25 / $199.47	Professional	26	$51.87	$136.25	$199.47
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.95 / $72.50 / $106.14	Professional	TC	$33.95	$72.50	$106.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.49 / $207.50 / $292.30	Professional		$54.49	$207.50	$292.30
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.14 / $135.00 / $209.05	Professional	26	$40.14	$135.00	$209.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $14.35 / $72.50 / $83.25	Professional	TC	$14.35	$72.50	$83.25
United Facility/Professional Professional Modifier Low / Median / High Price $223.38 / $223.38 / $223.38	Professional		$223.38	$223.38	$223.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.52 / $108.56 / $162.84	Professional	26	$58.52	$108.56	$162.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.54 / $60.54 / $60.54	Professional	TC	$60.54	$60.54	$60.54