Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $239.71 / $239.71 / $239.71	Facility	26	$239.71	$239.71	$239.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.04 / $418.50 / $976.21	Professional		$340.04	$418.50	$976.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $72.55 / $341.09	Professional	26	$62.17	$72.55	$341.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $277.86 / $345.93 / $555.16	Professional	TC	$277.86	$345.93	$555.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $336.64 / $821.87 / $973.00	Professional		$336.64	$821.87	$973.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.79 / $263.27 / $285.13	Professional	26	$114.79	$263.27	$285.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.84 / $558.60 / $681.10	Professional	TC	$221.84	$558.60	$681.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $543.42 / $652.11 / $1,437.26	Professional		$543.42	$652.11	$1,437.26
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $183.58 / $225.50 / $555.16	Professional	26	$183.58	$225.50	$555.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $333.87 / $431.82 / $882.09	Professional	TC	$333.87	$431.82	$882.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $840.00 / $963.20 / $1,539.92	Professional		$840.00	$963.20	$1,539.92
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $283.75 / $306.45 / $516.29	Professional	26	$283.75	$306.45	$516.29
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $556.25 / $641.20 / $1,023.63	Professional	TC	$556.25	$641.20	$1,023.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $318.79 / $850.00 / $1,455.30	Professional		$318.79	$850.00	$1,455.30
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $221.45 / $346.50 / $516.29	Professional	26	$221.45	$346.50	$516.29
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $567.50 / $687.00 / $1,023.63	Professional	TC	$567.50	$687.00	$1,023.63
United Facility/Professional Professional Modifier Low / Median / High Price $516.97 / $597.36 / $1,323.92	Professional		$516.97	$597.36	$1,323.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.35 / $341.70 / $545.16	Professional	26	$98.35	$341.70	$545.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $369.26 / $553.89 / $882.53	Professional	TC	$369.26	$553.89	$882.53