Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.05 / $145.94 / $235.64	Professional		$116.05	$145.94	$235.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.24 / $100.29 / $176.43	Professional	26	$83.24	$100.29	$176.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.81 / $45.65 / $59.21	Professional	TC	$32.81	$45.65	$59.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.84 / $110.52 / $355.13	Professional		$79.84	$110.52	$355.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.31 / $79.42 / $290.38	Professional	26	$62.31	$79.42	$290.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.52 / $26.32 / $64.75	Professional	TC	$17.52	$26.32	$64.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $185.40 / $304.70 / $388.95	Professional		$185.40	$304.70	$388.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $142.13 / $220.29 / $228.60	Professional	26	$142.13	$220.29	$228.60
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.27 / $81.61 / $84.42	Professional	TC	$43.27	$81.61	$84.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.24 / $201.60 / $432.00	Professional		$146.24	$201.60	$432.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.00 / $158.19 / $306.45	Professional	26	$112.00	$158.19	$306.45
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.65 / $47.00 / $125.55	Professional	TC	$34.65	$47.00	$125.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.85 / $170.48 / $456.00	Professional		$103.85	$170.48	$456.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $79.42 / $133.06 / $339.00	Professional	26	$79.42	$133.06	$339.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $44.85 / $117.00	Professional	TC	$29.49	$44.85	$117.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.05 / $273.31 / $284.70	Professional		$92.05	$273.31	$284.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.04 / $196.75 / $222.08	Professional	26	$73.04	$196.75	$222.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.67 / $62.62 / $63.00	Professional	TC	$19.67	$62.62	$63.00