Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.77 / $345.79 / $345.79	Professional		$152.77	$345.79	$345.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $235.00 / $1,041.52	Professional	26	$56.23	$235.00	$1,041.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.54 / $218.53 / $218.53	Professional	TC	$96.54	$218.53	$218.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $78.45 / $78.45	Professional		$78.45	$78.45	$78.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.02 / $27.02 / $27.02	Professional	26	$27.02	$27.02	$27.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.43 / $51.43 / $51.43	Professional	TC	$51.43	$51.43	$51.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $372.48 / $505.75	Professional		$39.43	$372.48	$505.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.64 / $77.64 / $77.64	Professional	26	$77.64	$77.64	$77.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $155.62 / $155.62 / $155.62	Professional	TC	$155.62	$155.62	$155.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.11 / $361.25 / $528.87	Professional		$89.11	$361.25	$528.87
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.76 / $102.50 / $150.06	Professional	26	$28.76	$102.50	$150.06
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.35 / $258.75 / $378.81	Professional	TC	$60.35	$258.75	$378.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $340.00 / $486.55	Professional		$78.45	$340.00	$486.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.02 / $101.25 / $153.55	Professional	26	$27.02	$101.25	$153.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $51.43 / $238.75 / $333.00	Professional	TC	$51.43	$238.75	$333.00
United Facility/Professional Professional Modifier Low / Median / High Price $338.58 / $338.58 / $338.58	Professional		$338.58	$338.58	$338.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $121.92 / $121.92 / $121.92	Professional	26	$121.92	$121.92	$121.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.14 / $111.14 / $216.66	Professional	TC	$111.14	$111.14	$216.66