Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.94 / $87.08 / $170.84	Professional		$70.94	$87.08	$170.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.01 / $48.75 / $106.80	Professional	26	$40.01	$48.75	$106.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.92 / $38.32 / $64.05	Professional	TC	$30.92	$38.32	$64.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.91 / $65.68 / $217.19	Professional		$50.91	$65.68	$217.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.04 / $37.15 / $138.79	Professional	26	$30.04	$37.15	$138.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.86 / $28.53 / $78.40	Professional	TC	$20.86	$28.53	$78.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $108.42 / $185.34 / $227.46	Professional		$108.42	$185.34	$227.46
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.65 / $104.08 / $108.81	Professional	26	$67.65	$104.08	$108.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.77 / $76.91 / $79.56	Professional	TC	$40.77	$76.91	$79.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.50 / $128.80 / $257.85	Professional		$89.50	$128.80	$257.85
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.50 / $76.30 / $147.15	Professional	26	$53.50	$76.30	$147.15
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.47 / $52.50 / $110.70	Professional	TC	$37.47	$52.50	$110.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.68 / $108.70 / $268.50	Professional		$65.68	$108.70	$268.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $45.20 / $75.20 / $160.50	Professional	26	$45.20	$75.20	$160.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.53 / $50.40 / $108.00	Professional	TC	$28.53	$50.40	$108.00
United Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $161.53 / $184.01	Professional		$50.72	$161.53	$184.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.42 / $92.80 / $109.00	Professional	26	$34.42	$92.80	$109.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.50 / $57.78 / $75.01	Professional	TC	$17.50	$57.78	$75.01