Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.87 / $65.87 / $65.87	Facility	26	$65.87	$65.87	$65.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.13 / $198.99 / $341.21	Professional		$181.13	$198.99	$341.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.63 / $30.36 / $53.87	Professional	26	$20.63	$30.36	$53.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $150.77 / $178.34 / $229.82	Professional	TC	$150.77	$178.34	$229.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.08 / $193.94 / $380.28	Professional		$119.08	$193.94	$380.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.65 / $36.27 / $86.56	Professional	26	$23.65	$36.27	$86.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.04 / $152.33 / $293.72	Professional	TC	$95.04	$152.33	$293.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $288.85 / $357.12 / $696.70	Professional		$288.85	$357.12	$696.70
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.80 / $66.95 / $154.93	Professional	26	$55.80	$66.95	$154.93
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $241.80 / $290.16 / $541.80	Professional	TC	$241.80	$290.16	$541.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.70 / $504.90 / $673.44	Professional		$381.70	$504.90	$673.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.52 / $94.50 / $127.27	Professional	26	$65.52	$94.50	$127.27
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $317.89 / $410.40 / $543.12	Professional	TC	$317.89	$410.40	$543.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $146.12 / $364.56 / $652.47	Professional		$146.12	$364.56	$652.47
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $44.96 / $104.40 / $138.53	Professional	26	$44.96	$104.40	$138.53
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $167.13 / $429.20 / $561.80	Professional	TC	$167.13	$429.20	$561.80
United Facility/Professional Professional Modifier Low / Median / High Price $167.30 / $304.22 / $608.44	Professional		$167.30	$304.22	$608.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.50 / $69.23 / $138.47	Professional	26	$28.50	$69.23	$138.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.98 / $234.98 / $469.96	Professional	TC	$201.98	$234.98	$469.96