Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $51.29 / $51.29	Professional	26	$51.29	$51.29	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	TC	$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Professional		$70.79	$70.79	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Professional	26	$26.30	$26.30	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	TC	$44.67	$44.67	$44.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $331.13	Professional		$162.18	$162.18	$331.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	26	$72.44	$72.44	$72.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	TC	$91.20	$91.20	$91.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $316.23 / $363.08	Professional		$79.43	$316.23	$363.08
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $112.20 / $134.90	Professional	26	$27.54	$112.20	$134.90
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $204.17 / $229.09	Professional	TC	$51.29	$204.17	$229.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Professional		$70.79	$70.79	$70.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Professional	26	$26.30	$26.30	$26.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	TC	$44.67	$44.67	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $181.97 / $275.42	Professional		$75.86	$181.97	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $77.62 / $117.49	Professional	26	$27.54	$77.62	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $104.71 / $158.49	Professional	TC	$46.77	$104.71	$158.49