Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $154.88	Professional		$81.28	$102.33	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $53.70 / $83.18	Professional	TC	$39.81	$53.70	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $251.19 / $309.03	Professional		$223.87	$251.19	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $125.89 / $141.25	Professional	TC	$112.20	$125.89	$141.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $245.47 / $416.87	Professional		$97.72	$245.47	$416.87
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $114.82 / $181.97	Professional	TC	$52.48	$114.82	$181.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $380.19 / $489.78	Professional		$186.21	$380.19	$489.78
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $199.53 / $239.88	Professional	TC	$93.33	$199.53	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $234.42 / $309.03	Professional		$109.65	$234.42	$309.03
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $89.13 / $151.36	Professional	TC	$44.67	$89.13	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $251.19 / $537.03	Professional		$93.33	$251.19	$537.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $112.20 / $245.47	Professional	TC	$46.77	$112.20	$245.47