Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.81 / $256.81 / $256.81	Facility	26	$256.81	$256.81	$256.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $319.01 / $382.87 / $1,534.22	Professional		$319.01	$382.87	$1,534.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.67 / $100.63 / $406.15	Professional	26	$87.67	$100.63	$406.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $231.34 / $282.23 / $953.94	Professional	TC	$231.34	$282.23	$953.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $882.91 / $882.91 / $882.91	Professional		$882.91	$882.91	$882.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $257.92 / $257.92 / $298.69	Professional	26	$257.92	$257.92	$298.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $447.62 / $447.62 / $584.22	Professional	TC	$447.62	$447.62	$584.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $672.80 / $1,747.20 / $2,207.79	Professional		$672.80	$1,747.20	$2,207.79
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $202.18 / $324.18 / $707.46	Professional	26	$202.18	$324.18	$707.46
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $470.65 / $609.57 / $1,500.33	Professional	TC	$470.65	$609.57	$1,500.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,040.00 / $1,216.34 / $1,707.10	Professional		$1,040.00	$1,216.34	$1,707.10
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $312.50 / $362.50 / $541.20	Professional	26	$312.50	$362.50	$541.20
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $727.50 / $881.55 / $1,178.20	Professional	TC	$727.50	$881.55	$1,178.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $377.15 / $1,234.50 / $1,770.62	Professional		$377.15	$1,234.50	$1,770.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $307.50 / $410.85 / $562.11	Professional	26	$307.50	$410.85	$562.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $786.00 / $994.00 / $1,220.94	Professional	TC	$786.00	$994.00	$1,220.94
United Facility/Professional Professional Modifier Low / Median / High Price $652.86 / $706.34 / $1,501.58	Professional		$652.86	$706.34	$1,501.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $118.85 / $240.88 / $554.03	Professional	26	$118.85	$240.88	$554.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $411.98 / $701.07 / $947.55	Professional	TC	$411.98	$701.07	$947.55