Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.78 / $458.98 / $458.98	Professional		$202.78	$458.98	$458.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.93 / $131.12 / $131.12	Professional	26	$57.93	$131.12	$131.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.85 / $327.86 / $327.86	Professional	TC	$144.85	$327.86	$327.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.83 / $84.83 / $84.83	Professional		$84.83	$84.83	$84.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.60 / $35.60 / $35.60	Professional	26	$35.60	$35.60	$35.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.23 / $49.23 / $49.23	Professional	TC	$49.23	$49.23	$49.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $265.35 / $265.35 / $579.25	Professional		$265.35	$265.35	$579.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	26	$80.00	$80.00	$80.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $185.35 / $185.35 / $185.35	Professional	TC	$185.35	$185.35	$185.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.24 / $413.75 / $605.73	Professional		$95.24	$413.75	$605.73
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.72 / $105.00 / $153.72	Professional	26	$37.72	$105.00	$153.72
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.52 / $308.75 / $452.01	Professional	TC	$57.52	$308.75	$452.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $84.83 / $379.25 / $475.50	Professional		$84.83	$379.25	$475.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $35.60 / $105.00 / $155.40	Professional	26	$35.60	$105.00	$155.40
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $49.23 / $223.85 / $349.50	Professional	TC	$49.23	$223.85	$349.50
United Facility/Professional Professional Modifier Low / Median / High Price $339.33 / $339.33 / $339.33	Professional		$339.33	$339.33	$339.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $125.58 / $125.58 / $125.58	Professional	26	$125.58	$125.58	$125.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.75 / $213.75 / $213.75	Professional	TC	$213.75	$213.75	$213.75