Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.93 / $370.41 / $1,348.48	Facility		$173.93	$370.41	$1,348.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.88 / $115.93 / $115.93	Facility	26	$103.88	$115.93	$115.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.53 / $211.82 / $296.33	Professional		$148.53	$211.82	$296.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.97 / $56.23 / $92.75	Professional	26	$38.97	$56.23	$92.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.32 / $156.36 / $203.59	Professional	TC	$109.32	$156.36	$203.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $362.61 / $381.56 / $499.72	Professional		$362.61	$381.56	$499.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.13 / $120.15 / $147.09	Professional	26	$109.13	$120.15	$147.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $242.46 / $272.43 / $352.63	Professional	TC	$242.46	$272.43	$352.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $145.35 / $296.33 / $453.38	Facility		$145.35	$296.33	$453.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $246.64 / $373.59 / $508.73	Professional		$246.64	$373.59	$508.73
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.00 / $111.60 / $179.41	Professional	26	$93.00	$111.60	$179.41
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $202.29 / $262.02 / $329.32	Professional	TC	$202.29	$262.02	$329.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.90 / $519.75 / $711.00	Professional		$225.90	$519.75	$711.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.00 / $150.00 / $210.45	Professional	26	$60.00	$150.00	$210.45
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.00 / $385.00 / $531.00	Professional	TC	$177.00	$385.00	$531.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $145.35 / $296.33 / $453.38	Facility		$145.35	$296.33	$453.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $175.87 / $386.07 / $806.40	Professional		$175.87	$386.07	$806.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $73.50 / $145.00 / $288.60	Professional	26	$73.50	$145.00	$288.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $180.00 / $391.20 / $690.30	Professional	TC	$180.00	$391.20	$690.30
United Facility/Professional Professional Modifier Low / Median / High Price $382.35 / $399.78 / $863.07	Professional		$382.35	$399.78	$863.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.26 / $117.66 / $254.01	Professional	26	$102.26	$117.66	$254.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $280.08 / $282.12 / $564.24	Professional	TC	$280.08	$282.12	$564.24