Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $331.13	Facility	26	$331.13	$331.13	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $446.68 / $1,548.82	Professional		$354.81	$446.68	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $134.90 / $501.19	Professional	26	$100.00	$134.90	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $309.03 / $1,047.13	Professional	TC	$229.09	$309.03	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional		$1,071.52	$1,071.52	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $323.59 / $371.54	Professional	26	$323.59	$323.59	$371.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $524.81 / $691.83	Professional	TC	$524.81	$524.81	$691.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,071.52 / $2,290.87	Professional		$724.44	$1,071.52	$2,290.87
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $338.84 / $758.58	Professional	26	$263.03	$338.84	$758.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $562.34 / $724.44 / $1,513.56	Professional	TC	$562.34	$724.44	$1,513.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,479.11 / $1,949.84	Professional		$1,380.38	$1,479.11	$1,949.84
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $426.58 / $660.69	Professional	26	$426.58	$426.58	$660.69
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $954.99 / $1,071.52 / $1,318.26	Professional	TC	$954.99	$1,071.52	$1,318.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $446.68 / $1,071.52	Professional		$309.03	$446.68	$1,071.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $144.54 / $371.54	Professional	26	$102.33	$144.54	$371.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $302.00 / $691.83	Professional	TC	$208.93	$302.00	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $851.14 / $1,778.28	Professional		$436.52	$851.14	$1,778.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $302.00 / $691.83	Professional	26	$158.49	$302.00	$691.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $549.54 / $1,071.52	Professional	TC	$269.15	$549.54	$1,071.52