Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $269.15	Professional		$194.98	$194.98	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	26	$66.07	$66.07	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $144.54 / $208.93	Professional	TC	$125.89	$144.54	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	26	$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $549.54	Professional		$263.03	$263.03	$549.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $93.33 / $93.33	Professional	26	$93.33	$93.33	$93.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	TC	$169.82	$169.82	$169.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $501.19 / $602.56	Professional		$338.84	$501.19	$602.56
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $144.54 / $173.78	Professional	26	$83.18	$144.54	$173.78
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $354.81 / $426.58	Professional	TC	$257.04	$354.81	$426.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	26	$87.10	$87.10	$87.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $275.42 / $416.87	Professional		$114.82	$275.42	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $100.00 / $147.91	Professional	26	$35.48	$100.00	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $177.83 / $263.03	Professional	TC	$79.43	$177.83	$263.03