Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.66 / $172.66 / $172.66	Facility	26	$172.66	$172.66	$172.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.77 / $345.12 / $484.56	Professional		$229.77	$345.12	$484.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.05 / $84.05 / $172.66	Professional	26	$69.05	$84.05	$172.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.77 / $261.07 / $329.07	Professional	TC	$159.77	$261.07	$329.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.20 / $369.26 / $705.65	Professional		$220.20	$369.26	$705.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.27 / $90.27 / $225.32	Professional	26	$62.27	$90.27	$225.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.91 / $232.25 / $480.33	Professional	TC	$157.91	$232.25	$480.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $520.41 / $625.89 / $1,260.63	Professional		$520.41	$625.89	$1,260.63
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.55 / $174.66 / $408.60	Professional	26	$145.55	$174.66	$408.60
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $348.56 / $451.23 / $851.99	Professional	TC	$348.56	$451.23	$851.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $734.80 / $888.30 / $1,198.75	Professional		$734.80	$888.30	$1,198.75
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $195.48 / $243.00 / $329.40	Professional	26	$195.48	$243.00	$329.40
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $536.79 / $645.29 / $882.00	Professional	TC	$536.79	$645.29	$882.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $252.28 / $645.82 / $1,198.75	Professional		$252.28	$645.82	$1,198.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $116.12 / $262.45 / $348.24	Professional	26	$116.12	$262.45	$348.24
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $250.01 / $713.40 / $932.40	Professional	TC	$250.01	$713.40	$932.40
United Facility/Professional Professional Modifier Low / Median / High Price $308.81 / $564.52 / $917.35	Professional		$308.81	$564.52	$917.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.50 / $180.26 / $292.93	Professional	26	$93.50	$180.26	$292.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.34 / $384.26 / $576.39	Professional	TC	$201.34	$384.26	$576.39