Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $221.97 / $221.97 / $221.97	Facility	26	$221.97	$221.97	$221.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $143.08 / $332.77	Professional		$130.08	$143.08	$332.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.34 / $82.55 / $181.51	Professional	26	$65.34	$82.55	$181.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $68.72 / $151.27	Professional	TC	$55.03	$68.72	$151.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $360.41 / $410.23 / $540.61	Professional		$360.41	$410.23	$540.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $187.74 / $212.66 / $287.83	Professional	26	$187.74	$212.66	$287.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.67 / $197.57 / $252.77	Professional	TC	$172.67	$197.57	$252.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $373.60 / $448.32 / $634.59	Professional		$373.60	$448.32	$634.59
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $191.65 / $229.98 / $359.77	Professional	26	$191.65	$229.98	$359.77
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $168.82 / $218.34 / $274.82	Professional	TC	$168.82	$218.34	$274.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.20 / $595.20 / $845.46	Professional		$223.20	$595.20	$845.46
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.77 / $296.25 / $419.73	Professional	26	$108.77	$296.25	$419.73
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.00 / $303.75 / $411.75	Professional	TC	$117.00	$303.75	$411.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $203.74 / $404.39 / $776.00	Professional		$203.74	$404.39	$776.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $119.50 / $287.83 / $466.05	Professional	26	$119.50	$287.83	$466.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $127.00 / $300.00 / $507.00	Professional	TC	$127.00	$300.00	$507.00
United Facility/Professional Professional Modifier Low / Median / High Price $411.55 / $432.48 / $864.96	Professional		$411.55	$432.48	$864.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $203.62 / $230.26 / $497.10	Professional	26	$203.62	$230.26	$497.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $202.22 / $202.22 / $353.88	Professional	TC	$202.22	$202.22	$353.88