Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.75 / $481.57 / $481.57	Professional		$212.75	$481.57	$481.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.87 / $201.16 / $855.40	Professional	26	$88.87	$201.16	$855.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.88 / $280.39 / $280.39	Professional	TC	$123.88	$280.39	$280.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.85 / $185.85 / $185.85	Professional		$185.85	$185.85	$185.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.34 / $80.34 / $80.34	Professional	26	$80.34	$80.34	$80.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.50 / $105.50 / $105.50	Professional	TC	$105.50	$105.50	$105.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $287.86 / $287.86 / $607.25	Professional		$287.86	$287.86	$607.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.32 / $121.32 / $121.32	Professional	26	$121.32	$121.32	$121.32
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $166.56 / $166.56 / $166.56	Professional	TC	$166.56	$166.56	$166.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.93 / $433.75 / $635.01	Professional		$207.93	$433.75	$635.01
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.27 / $156.25 / $228.75	Professional	26	$78.27	$156.25	$228.75
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.66 / $277.50 / $406.26	Professional	TC	$129.66	$277.50	$406.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $185.85 / $447.50 / $762.20	Professional		$185.85	$447.50	$762.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $80.34 / $157.50 / $255.30	Professional	26	$80.34	$157.50	$255.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $105.50 / $290.00 / $506.90	Professional	TC	$105.50	$290.00	$506.90
United Facility/Professional Professional Modifier Low / Median / High Price $471.63 / $471.63 / $471.63	Professional		$471.63	$471.63	$471.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $194.94 / $194.94 / $194.94	Professional	26	$194.94	$194.94	$194.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.20 / $184.46 / $276.69	Professional	TC	$119.20	$184.46	$276.69