Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $74.84	Facility	26	$74.84	$74.84	$74.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.52 / $159.41 / $321.20	Professional		$103.52	$159.41	$321.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.88 / $128.74 / $260.01	Professional	TC	$81.88	$128.74	$260.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.49 / $332.71 / $394.81	Professional		$321.49	$332.71	$394.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $250.67 / $268.87 / $299.36	Professional	TC	$250.67	$268.87	$299.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $411.38 / $513.33 / $669.69	Professional		$411.38	$513.33	$669.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $336.20 / $435.72 / $547.29	Professional	TC	$336.20	$435.72	$547.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.50 / $544.79 / $860.95	Professional		$223.50	$544.79	$860.95
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $184.50 / $451.20 / $719.55	Professional	TC	$184.50	$451.20	$719.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $209.23 / $367.65 / $744.00	Professional		$209.23	$367.65	$744.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $184.50 / $447.00 / $706.07	Professional	TC	$184.50	$447.00	$706.07
United Facility/Professional Professional Modifier Low / Median / High Price $315.86 / $315.86 / $631.72	Professional		$315.86	$315.86	$631.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.50 / $239.50 / $407.39	Professional	TC	$239.50	$239.50	$407.39