Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $251.19 / $269.15	Professional		$229.09	$251.19	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $83.18 / $83.18	Professional	26	$67.61	$83.18	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $169.82 / $199.53	Professional	TC	$162.18	$169.82	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	26	$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	TC	$74.13	$74.13	$74.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $758.58	Professional		$363.08	$363.08	$758.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Professional	26	$117.49	$117.49	$117.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $239.88 / $239.88	Professional	TC	$239.88	$239.88	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $588.84 / $812.83	Professional		$309.03	$588.84	$812.83
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $177.83 / $223.87	Professional	26	$85.11	$177.83	$223.87
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $407.38 / $588.84	Professional	TC	$218.78	$407.38	$588.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	26	$95.50	$95.50	$95.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	TC	$74.13	$74.13	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $323.59 / $478.63	Professional		$134.90	$323.59	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $120.23 / $181.97	Professional	26	$43.65	$120.23	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $204.17 / $302.00	Professional	TC	$91.20	$204.17	$302.00