Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $79.77 / $228.56	Professional		$68.06	$79.77	$228.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $20.47 / $71.98	Professional	26	$17.82	$20.47	$71.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.22 / $59.30 / $156.57	Professional	TC	$50.22	$59.30	$156.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.13 / $220.29 / $397.25	Professional		$102.13	$220.29	$397.25
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.13 / $60.15 / $64.56	Professional	26	$50.13	$60.15	$64.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.43 / $160.11 / $171.85	Professional	TC	$133.43	$160.11	$171.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $268.75 / $305.10 / $655.75	Professional		$268.75	$305.10	$655.75
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.75 / $82.35 / $179.95	Professional	26	$73.75	$82.35	$179.95
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.00 / $222.75 / $475.80	Professional	TC	$195.00	$222.75	$475.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.79 / $318.00 / $655.75	Professional		$151.79	$318.00	$655.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $73.20 / $87.00 / $179.95	Professional	26	$73.20	$87.00	$179.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $194.40 / $231.00 / $475.80	Professional	TC	$194.40	$231.00	$475.80
United Facility/Professional Professional Modifier Low / Median / High Price $179.87 / $271.74 / $1,036.63	Professional		$179.87	$271.74	$1,036.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.00 / $85.83 / $327.43	Professional	26	$26.00	$85.83	$327.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.94 / $185.91 / $709.20	Professional	TC	$123.94	$185.91	$709.20