Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $478.63	Professional		$380.19	$478.63	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $83.18	Professional	26	$54.95	$83.18	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $398.11 / $398.11	Professional	TC	$323.59	$398.11	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	26	$56.23	$56.23	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $177.83 / $177.83	Professional	TC	$177.83	$177.83	$177.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $630.96 / $1,380.38	Professional		$173.78	$630.96	$1,380.38
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $117.49 / $117.49	Professional	26	$37.15	$117.49	$117.49
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $524.81 / $524.81	Professional	TC	$138.04	$524.81	$524.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $1,479.11 / $1,513.56	Professional		$269.15	$1,479.11	$1,513.56
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $190.55 / $223.87	Professional	26	$58.88	$190.55	$223.87
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $1,288.25 / $1,318.26	Professional	TC	$208.93	$1,288.25	$1,318.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	26	$56.23	$56.23	$56.23
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $177.83 / $177.83	Professional	TC	$177.83	$177.83	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $812.83 / $1,202.26	Professional		$346.74	$812.83	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $128.82 / $194.98	Professional	26	$45.71	$128.82	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $676.08 / $1,023.29	Professional	TC	$302.00	$676.08	$1,023.29