Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $231.99 / $231.99 / $231.99	Facility	26	$231.99	$231.99	$231.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.73 / $349.28 / $936.11	Professional		$269.73	$349.28	$936.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.99 / $113.06 / $208.90	Professional	26	$95.99	$113.06	$208.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.59 / $236.23 / $311.39	Professional	TC	$172.59	$236.23	$311.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.15 / $424.53 / $725.37	Professional		$251.15	$424.53	$725.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.07 / $123.39 / $301.95	Professional	26	$83.07	$123.39	$301.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.08 / $230.79 / $460.77	Professional	TC	$168.08	$230.79	$460.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $556.35 / $667.62 / $1,357.29	Professional		$556.35	$667.62	$1,357.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $195.70 / $234.84 / $548.99	Professional	26	$195.70	$234.84	$548.99
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $360.68 / $432.81 / $808.30	Professional	TC	$360.68	$432.81	$808.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $753.53 / $939.60 / $1,233.18	Professional		$753.53	$939.60	$1,233.18
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $261.36 / $326.70 / $442.86	Professional	26	$261.36	$326.70	$442.86
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $516.14 / $612.90 / $783.06	Professional	TC	$516.14	$612.90	$783.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $301.01 / $696.15 / $1,177.67	Professional		$301.01	$696.15	$1,177.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $155.09 / $363.00 / $465.61	Professional	26	$155.09	$363.00	$465.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $269.44 / $631.50 / $943.20	Professional	TC	$269.44	$631.50	$943.20
United Facility/Professional Professional Modifier Low / Median / High Price $373.54 / $580.29 / $870.45	Professional		$373.54	$580.29	$870.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $144.86 / $241.56 / $392.54	Professional	26	$144.86	$241.56	$392.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.07 / $338.74 / $550.45	Professional	TC	$210.07	$338.74	$550.45