Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $187.87 / $187.87 / $187.87	Facility	26	$187.87	$187.87	$187.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.37 / $840.54 / $935.04	Professional		$368.37	$840.54	$935.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $244.99 / $267.31	Professional	26	$62.17	$244.99	$267.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $306.18 / $573.23 / $644.88	Professional	TC	$306.18	$573.23	$644.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.05 / $787.04 / $973.00	Professional		$320.05	$787.04	$973.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.26 / $206.73 / $276.00	Professional	26	$90.26	$206.73	$276.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.79 / $580.32 / $726.52	Professional	TC	$229.79	$580.32	$726.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $514.66 / $620.07 / $1,351.41	Professional		$514.66	$620.07	$1,351.41
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $143.94 / $176.65 / $436.21	Professional	26	$143.94	$176.65	$436.21
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $345.89 / $447.36 / $915.20	Professional	TC	$345.89	$447.36	$915.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $798.75 / $1,056.25 / $1,557.80	Professional		$798.75	$1,056.25	$1,557.80
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $222.50 / $267.80 / $412.00	Professional	26	$222.50	$267.80	$412.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $576.25 / $798.75 / $1,157.73	Professional	TC	$576.25	$798.75	$1,157.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $299.74 / $912.00 / $1,557.80	Professional		$299.74	$912.00	$1,557.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $214.80 / $268.50 / $412.00	Professional	26	$214.80	$268.50	$412.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $588.75 / $777.51 / $1,288.00	Professional	TC	$588.75	$777.51	$1,288.00
United Facility/Professional Professional Modifier Low / Median / High Price $563.63 / $892.26 / $1,592.61	Professional		$563.63	$892.26	$1,592.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.92 / $266.22 / $449.29	Professional	26	$98.92	$266.22	$449.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $417.35 / $626.04 / $1,143.32	Professional	TC	$417.35	$626.04	$1,143.32