Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $437.55 / $990.39 / $990.39	Professional		$437.55	$990.39	$990.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $253.73 / $574.32 / $574.32	Professional	26	$253.73	$574.32	$574.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $183.82 / $416.07 / $416.07	Professional	TC	$183.82	$416.07	$416.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.43 / $324.43 / $324.43	Professional		$324.43	$324.43	$324.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $202.96 / $202.96 / $202.96	Professional	26	$202.96	$202.96	$202.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.47 / $121.47 / $121.47	Professional	TC	$121.47	$121.47	$121.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $611.79 / $611.79 / $1,239.00	Professional		$611.79	$611.79	$1,239.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $346.62 / $346.62 / $346.62	Professional	26	$346.62	$346.62	$346.62
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $265.18 / $265.18 / $265.18	Professional	TC	$265.18	$265.18	$265.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.24 / $885.00 / $1,295.64	Professional		$368.24	$885.00	$1,295.64
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $176.34 / $441.25 / $645.99	Professional	26	$176.34	$441.25	$645.99
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.90 / $443.75 / $649.65	Professional	TC	$191.90	$443.75	$649.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $324.43 / $882.50 / $1,158.09	Professional		$324.43	$882.50	$1,158.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $202.96 / $443.75 / $666.00	Professional	26	$202.96	$443.75	$666.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $121.47 / $438.75 / $492.10	Professional	TC	$121.47	$438.75	$492.10
United Facility/Professional Professional Modifier Low / Median / High Price $611.34 / $611.34 / $917.01	Professional		$611.34	$611.34	$917.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $562.41 / $562.41 / $562.41	Professional	26	$562.41	$562.41	$562.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $354.60 / $354.60 / $354.60	Professional	TC	$354.60	$354.60	$354.60