Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.50 / $772.99 / $772.99	Professional		$341.50	$772.99	$772.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.46 / $109.67 / $109.67	Professional	26	$48.46	$109.67	$109.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $293.06 / $663.32 / $663.32	Professional	TC	$293.06	$663.32	$663.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.92 / $238.92 / $238.92	Professional		$238.92	$238.92	$238.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.09 / $66.09 / $66.09	Professional	26	$66.09	$66.09	$66.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.83 / $172.83 / $172.83	Professional	TC	$172.83	$172.83	$172.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $452.04 / $452.04 / $1,020.25	Professional		$452.04	$452.04	$1,020.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.22 / $66.22 / $66.22	Professional	26	$66.22	$66.22	$66.22
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $385.82 / $385.82 / $385.82	Professional	TC	$385.82	$385.82	$385.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.70 / $728.75 / $1,066.89	Professional		$211.70	$728.75	$1,066.89
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.61 / $85.00 / $124.44	Professional	26	$72.61	$85.00	$124.44
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.09 / $643.75 / $942.45	Professional	TC	$139.09	$643.75	$942.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $238.92 / $641.95 / $880.50	Professional		$238.92	$641.95	$880.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $66.09 / $85.00 / $135.05	Professional	26	$66.09	$85.00	$135.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $172.83 / $506.90 / $774.00	Professional	TC	$172.83	$506.90	$774.00
United Facility/Professional Professional Modifier Low / Median / High Price $633.63 / $633.63 / $633.63	Professional		$633.63	$633.63	$633.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.57 / $108.57 / $108.57	Professional	26	$108.57	$108.57	$108.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $350.04 / $350.04 / $525.05	Professional	TC	$350.04	$350.04	$525.05