Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.22 / $69.22 / $69.22	Facility	26	$69.22	$69.22	$69.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.65 / $184.08 / $253.92	Professional		$101.65	$184.08	$253.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $32.61 / $56.60	Professional	26	$32.15	$32.61	$56.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $151.91 / $197.32	Professional	TC	$69.04	$151.91	$197.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.01 / $249.23 / $477.34	Professional		$144.01	$249.23	$477.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.76 / $46.02 / $90.82	Professional	26	$24.76	$46.02	$90.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.86 / $212.41 / $386.52	Professional	TC	$120.86	$212.41	$386.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $382.33 / $468.69 / $886.83	Professional		$382.33	$468.69	$886.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.73 / $102.87 / $173.74	Professional	26	$85.73	$102.87	$173.74
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $304.88 / $365.85 / $724.12	Professional	TC	$304.88	$365.85	$724.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $477.36 / $646.65 / $853.74	Professional		$477.36	$646.65	$853.74
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.92 / $111.00 / $153.69	Professional	26	$79.92	$111.00	$153.69
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $397.44 / $548.10 / $689.91	Professional	TC	$397.44	$548.10	$689.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $212.33 / $467.46 / $801.25	Professional		$212.33	$467.46	$801.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $46.02 / $105.85 / $144.30	Professional	26	$46.02	$105.85	$144.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $212.41 / $551.10 / $738.82	Professional	TC	$212.41	$551.10	$738.82
United Facility/Professional Professional Modifier Low / Median / High Price $288.64 / $381.88 / $763.76	Professional		$288.64	$381.88	$763.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.50 / $72.66 / $145.32	Professional	26	$43.50	$72.66	$145.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.66 / $309.22 / $618.44	Professional	TC	$245.66	$309.22	$618.44