Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.36 / $86.36 / $254.14	Facility	26	$86.36	$86.36	$254.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.34 / $313.72 / $745.59	Professional		$145.34	$313.72	$745.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.52 / $86.36 / $224.37	Professional	26	$48.52	$86.36	$224.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $514.60 / $565.11	Professional	TC	$96.82	$514.60	$565.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.86 / $147.40 / $217.25	Professional		$103.86	$147.40	$217.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.67 / $63.04 / $80.65	Professional	26	$39.67	$63.04	$80.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.19 / $66.76 / $154.19	Professional	TC	$64.19	$66.76	$154.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $237.03 / $506.55 / $913.50	Professional		$237.03	$506.55	$913.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.28 / $120.33 / $129.15	Professional	26	$100.28	$120.33	$129.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $321.85 / $386.22 / $414.54	Professional	TC	$321.85	$386.22	$414.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $623.75 / $718.20 / $955.26	Professional		$623.75	$718.20	$955.26
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $155.00 / $167.40 / $226.92	Professional	26	$155.00	$167.40	$226.92
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $465.00 / $550.79 / $728.34	Professional	TC	$465.00	$550.79	$728.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.40 / $665.00 / $1,165.34	Professional		$147.40	$665.00	$1,165.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $63.04 / $189.00 / $294.77	Professional	26	$63.04	$189.00	$294.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $66.76 / $574.50 / $870.59	Professional	TC	$66.76	$574.50	$870.59
United Facility/Professional Professional Modifier Low / Median / High Price $203.74 / $434.50 / $651.75	Professional		$203.74	$434.50	$651.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $127.42 / $189.12	Professional	26	$79.06	$127.42	$189.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.68 / $308.42 / $462.63	Professional	TC	$124.68	$308.42	$462.63