Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.17 / $281.08 / $281.08	Professional		$124.17	$281.08	$281.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.90 / $117.50 / $117.50	Professional	26	$51.90	$117.50	$117.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.27 / $163.59 / $163.59	Professional	TC	$72.27	$163.59	$163.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.45 / $70.45 / $70.45	Professional		$70.45	$70.45	$70.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $26.28 / $26.28	Professional	26	$26.28	$26.28	$26.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $44.17 / $44.17	Professional	TC	$44.17	$44.17	$44.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $164.67 / $164.67 / $344.75	Professional		$164.67	$164.67	$344.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.79 / $71.79 / $71.79	Professional	26	$71.79	$71.79	$71.79
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $92.88 / $92.88 / $92.88	Professional	TC	$92.88	$92.88	$92.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.68 / $246.25 / $360.51	Professional		$79.68	$246.25	$360.51
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.82 / $91.25 / $133.59	Professional	26	$27.82	$91.25	$133.59
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.87 / $155.00 / $226.92	Professional	TC	$51.87	$155.00	$226.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.45 / $253.75 / $412.55	Professional		$70.45	$253.75	$412.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $91.25 / $148.00	Professional	26	$26.28	$91.25	$148.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $162.50 / $264.55	Professional	TC	$44.17	$162.50	$264.55
United Facility/Professional Professional Modifier Low / Median / High Price $275.27 / $275.27 / $275.27	Professional		$275.27	$275.27	$275.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.70 / $116.70 / $116.70	Professional	26	$116.70	$116.70	$116.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.58 / $158.58 / $158.58	Professional	TC	$158.58	$158.58	$158.58