Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $66.07	Professional	26	$52.48	$66.07	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	TC	$154.88	$154.88	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	26	$31.62	$31.62	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	TC	$54.95	$54.95	$54.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $676.08	Professional		$316.23	$316.23	$676.08
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 $223.87 / $223.87 / $223.87	Professional	TC	$223.87	$223.87	$223.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $512.86 / $724.44	Professional		$97.72	$512.86	$724.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $138.04 / $181.97	Professional	26	$33.11	$138.04	$181.97
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $371.54 / $537.03	Professional	TC	$64.57	$371.54	$537.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	26	$31.62	$31.62	$31.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	TC	$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $281.84 / $416.87	Professional		$117.49	$281.84	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $95.50 / $141.25	Professional	26	$33.88	$95.50	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $186.21 / $275.42	Professional	TC	$83.18	$186.21	$275.42