Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.36 / $485.20 / $485.20	Professional		$214.36	$485.20	$485.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.75 / $151.10 / $151.10	Professional	26	$66.75	$151.10	$151.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.60 / $334.10 / $334.10	Professional	TC	$147.60	$334.10	$334.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.98 / $85.98 / $85.98	Professional		$85.98	$85.98	$85.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.33 / $31.33 / $31.33	Professional	26	$31.33	$31.33	$31.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.65 / $54.65 / $54.65	Professional	TC	$54.65	$54.65	$54.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $314.42 / $314.42 / $686.00	Professional		$314.42	$314.42	$686.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $94.49 / $94.49 / $94.49	Professional	26	$94.49	$94.49	$94.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $219.92 / $219.92 / $219.92	Professional	TC	$219.92	$219.92	$219.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.13 / $490.00 / $717.36	Professional		$97.13	$490.00	$717.36
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.01 / $123.75 / $181.17	Professional	26	$33.01	$123.75	$181.17
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.12 / $366.25 / $536.19	Professional	TC	$64.12	$366.25	$536.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.98 / $481.25 / $573.50	Professional		$85.98	$481.25	$573.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.33 / $121.25 / $173.90	Professional	26	$31.33	$121.25	$173.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $54.65 / $360.00 / $399.60	Professional	TC	$54.65	$360.00	$399.60
United Facility/Professional Professional Modifier Low / Median / High Price $418.95 / $418.95 / $418.95	Professional		$418.95	$418.95	$418.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $142.22 / $142.22 / $142.22	Professional	26	$142.22	$142.22	$142.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $276.72 / $276.72 / $276.72	Professional	TC	$276.72	$276.72	$276.72