Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $346.74 / $1,071.52	Professional		$239.88	$346.74	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $213.80	Professional	26	$72.44	$104.71	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $181.97 / $331.13	Professional	TC	$151.36	$181.97	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $446.68 / $724.44	Professional		$251.19	$446.68	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $165.96 / $281.84	Professional	26	$83.18	$165.96	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $263.03 / $426.58	Professional	TC	$169.82	$263.03	$426.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $676.08 / $1,023.29	Professional		$389.05	$676.08	$1,023.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $251.19 / $416.87	Professional	26	$134.90	$251.19	$416.87
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $407.38 / $602.56	Professional	TC	$263.03	$407.38	$602.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $933.25 / $1,258.93	Professional		$812.83	$933.25	$1,258.93
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $323.59 / $446.68	Professional	26	$263.03	$323.59	$446.68
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $616.60 / $812.83	Professional	TC	$512.86	$616.60	$812.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $446.68 / $724.44	Professional		$245.47	$446.68	$724.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $114.82 / $302.00	Professional	26	$81.28	$114.82	$302.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $208.93 / $478.63	Professional	TC	$147.91	$208.93	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $575.44 / $758.58	Professional		$354.81	$575.44	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $239.88 / $302.00	Professional	26	$144.54	$239.88	$302.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $338.84 / $512.86	Professional	TC	$208.93	$338.84	$512.86