Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.49 / $218.49 / $406.69	Facility	26	$218.49	$218.49	$406.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,460.22	Professional		$475.00	$522.50	$1,460.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $428.30	Professional	26	$140.00	$154.00	$428.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,031.92	Professional	TC	$335.00	$368.50	$1,031.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $399.28 / $900.00 / $1,003.93	Professional		$399.28	$900.00	$1,003.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.98 / $240.27 / $270.00	Professional	26	$104.98	$240.27	$270.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $294.30 / $630.00 / $763.65	Professional	TC	$294.30	$630.00	$763.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $638.89 / $773.40 / $1,761.00	Professional		$638.89	$773.40	$1,761.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $167.40 / $205.49 / $507.65	Professional	26	$167.40	$205.49	$507.65
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $442.53 / $572.52 / $1,181.90	Professional	TC	$442.53	$572.52	$1,181.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $996.25 / $1,155.65 / $1,939.98	Professional		$996.25	$1,155.65	$1,939.98
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $258.75 / $279.45 / $469.35	Professional	26	$258.75	$279.45	$469.35
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $737.50 / $880.10 / $1,470.63	Professional	TC	$737.50	$880.10	$1,470.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $374.74 / $1,018.75 / $1,911.34	Professional		$374.74	$1,018.75	$1,911.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $225.03 / $315.00 / $469.35	Professional	26	$225.03	$315.00	$469.35
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $662.90 / $987.00 / $1,470.63	Professional	TC	$662.90	$987.00	$1,470.63
United Facility/Professional Professional Modifier Low / Median / High Price $737.53 / $1,106.94 / $2,788.00	Professional		$737.53	$1,106.94	$2,788.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $101.34 / $207.64 / $619.62	Professional	26	$101.34	$207.64	$619.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $530.32 / $718.49 / $2,041.00	Professional	TC	$530.32	$718.49	$2,041.00