Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $216.61 / $216.61 / $216.61	Facility	26	$216.61	$216.61	$216.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.11 / $147.16 / $344.91	Professional		$116.11	$147.16	$344.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.48 / $81.11 / $177.12	Professional	26	$63.48	$81.11	$177.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.63 / $61.75 / $104.92	Professional	TC	$52.63	$61.75	$104.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.54 / $346.55 / $464.40	Professional		$294.54	$346.55	$464.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $180.67 / $207.53 / $281.23	Professional	26	$180.67	$207.53	$281.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.87 / $139.01 / $183.17	Professional	TC	$113.87	$139.01	$183.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $321.05 / $385.26 / $553.70	Professional		$321.05	$385.26	$553.70
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $187.60 / $225.12 / $352.31	Professional	26	$187.60	$225.12	$352.31
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.71 / $160.11 / $201.39	Professional	TC	$123.71	$160.11	$201.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.05 / $525.00 / $742.05	Professional		$193.05	$525.00	$742.05
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.02 / $290.00 / $424.56	Professional	26	$106.02	$290.00	$424.56
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.00 / $222.75 / $332.95	Professional	TC	$87.00	$222.75	$332.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $170.57 / $343.20 / $793.65	Professional		$170.57	$343.20	$793.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $116.50 / $289.80 / $506.00	Professional	26	$116.50	$289.80	$506.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $94.50 / $212.50 / $437.80	Professional	TC	$94.50	$212.50	$437.80
United Facility/Professional Professional Modifier Low / Median / High Price $342.82 / $384.02 / $969.63	Professional		$342.82	$384.02	$969.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $198.48 / $224.98 / $566.29	Professional	26	$198.48	$224.98	$566.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.34 / $146.54 / $403.34	Professional	TC	$144.34	$146.54	$403.34