Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.41 / $68.41 / $201.31	Facility	26	$68.41	$68.41	$201.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $238.07 / $538.90	Professional		$86.29	$238.07	$538.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $68.41 / $154.85	Professional	26	$23.42	$68.41	$154.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.86 / $169.67 / $384.05	Professional	TC	$62.86	$169.67	$384.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.14 / $112.58 / $166.27	Professional		$53.14	$112.58	$166.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.63 / $33.75 / $49.83	Professional	26	$17.63	$33.75	$49.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.51 / $78.83 / $116.44	Professional	TC	$35.51	$78.83	$116.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $177.65 / $375.54 / $677.25	Professional		$177.65	$375.54	$677.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.25 / $95.10 / $102.07	Professional	26	$79.25	$95.10	$102.07
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $233.70 / $280.44 / $301.01	Professional	TC	$233.70	$280.44	$301.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.50 / $540.00 / $708.21	Professional		$467.50	$540.00	$708.21
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $122.50 / $132.30 / $179.34	Professional	26	$122.50	$132.30	$179.34
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $341.25 / $407.70 / $528.87	Professional	TC	$341.25	$407.70	$528.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.58 / $500.00 / $856.88	Professional		$112.58	$500.00	$856.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $150.00 / $233.07	Professional	26	$33.75	$150.00	$233.07
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $78.83 / $433.50 / $623.80	Professional	TC	$78.83	$433.50	$623.80
United Facility/Professional Professional Modifier Low / Median / High Price $144.33 / $332.54 / $498.81	Professional		$144.33	$332.54	$498.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.33 / $100.74 / $149.49	Professional	26	$40.33	$100.74	$149.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.00 / $349.32 / $349.32	Professional	TC	$104.00	$349.32	$349.32