Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $371.54 / $371.54 / $371.54	Facility	26	$371.54	$371.54	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $234.42 / $446.68	Professional		$199.53	$234.42	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $131.83 / $234.42	Professional	26	$114.82	$131.83	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $93.33 / $138.04	Professional	TC	$81.28	$93.33	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $549.54 / $741.31	Professional		$467.74	$549.54	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $346.74 / $467.74	Professional	26	$302.00	$346.74	$467.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $204.17 / $269.15	Professional	TC	$169.82	$204.17	$269.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $588.84 / $1,000.00	Professional		$218.78	$588.84	$1,000.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $389.05 / $660.69	Professional	26	$131.83	$389.05	$660.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $218.78 / $346.74	Professional	TC	$91.20	$218.78	$346.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $851.14 / $1,148.15	Professional		$446.68	$851.14	$1,148.15
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $257.04 / $524.81 / $676.08	Professional	26	$257.04	$524.81	$676.08
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $331.13 / $446.68	Professional	TC	$194.98	$331.13	$446.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $524.81 / $676.08	Professional		$239.88	$524.81	$676.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $234.42 / $467.74	Professional	26	$125.89	$234.42	$467.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $147.91 / $269.15	Professional	TC	$93.33	$147.91	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $588.84 / $1,819.70	Professional		$295.12	$588.84	$1,819.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $371.54 / $1,122.02	Professional	26	$186.21	$371.54	$1,122.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $213.80 / $707.95	Professional	TC	$109.65	$213.80	$707.95