Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.25 / $598.15 / $598.15	Professional		$264.25	$598.15	$598.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.97 / $162.91 / $162.91	Professional	26	$71.97	$162.91	$162.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.28 / $435.25 / $435.25	Professional	TC	$192.28	$435.25	$435.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.73 / $107.73 / $107.73	Professional		$107.73	$107.73	$107.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.76 / $57.76 / $57.76	Professional	26	$57.76	$57.76	$57.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.97 / $49.97 / $49.97	Professional	TC	$49.97	$49.97	$49.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $346.06 / $346.06 / $757.75	Professional		$346.06	$346.06	$757.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.42 / $99.42 / $99.42	Professional	26	$99.42	$99.42	$99.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $246.65 / $246.65 / $246.65	Professional	TC	$246.65	$246.65	$246.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.04 / $541.25 / $792.39	Professional		$140.04	$541.25	$792.39
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.58 / $130.00 / $190.32	Professional	26	$56.58	$130.00	$190.32
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.46 / $411.25 / $602.07	Professional	TC	$83.46	$411.25	$602.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.73 / $492.10 / $627.00	Professional		$107.73	$492.10	$627.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $57.76 / $130.00 / $194.25	Professional	26	$57.76	$130.00	$194.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $49.97 / $297.85 / $471.00	Professional	TC	$49.97	$297.85	$471.00
United Facility/Professional Professional Modifier Low / Median / High Price $460.53 / $460.53 / $460.53	Professional		$460.53	$460.53	$460.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $156.00 / $156.00 / $156.00	Professional	26	$156.00	$156.00	$156.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $176.65 / $203.02 / $304.52	Professional	TC	$176.65	$203.02	$304.52