Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $259.87 / $462.21 / $543.03	Facility	26	$259.87	$462.21	$543.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.88 / $474.59 / $1,109.54	Professional		$385.88	$474.59	$1,109.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.65 / $127.64 / $462.21	Professional	26	$75.65	$127.64	$462.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $310.24 / $386.24 / $662.30	Professional	TC	$310.24	$386.24	$662.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.88 / $920.00 / $1,325.33	Professional		$421.88	$920.00	$1,325.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.61 / $276.00 / $291.89	Professional	26	$124.61	$276.00	$291.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $297.27 / $644.00 / $1,057.68	Professional	TC	$297.27	$644.00	$1,057.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $481.98 / $817.08 / $1,774.36	Professional		$481.98	$817.08	$1,774.36
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $198.93 / $244.06 / $601.10	Professional	26	$198.93	$244.06	$601.10
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $447.05 / $578.37 / $1,173.26	Professional	TC	$447.05	$578.37	$1,173.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,052.50 / $1,163.40 / $1,866.23	Professional		$1,052.50	$1,163.40	$1,866.23
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $307.50 / $332.10 / $554.28	Professional	26	$307.50	$332.10	$554.28
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $745.00 / $815.40 / $1,311.95	Professional	TC	$745.00	$815.40	$1,311.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $393.55 / $1,061.25 / $1,740.90	Professional		$393.55	$1,061.25	$1,740.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $267.64 / $372.00 / $554.28	Professional	26	$267.64	$372.00	$554.28
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $681.10 / $880.50 / $1,311.95	Professional	TC	$681.10	$880.50	$1,311.95
United Facility/Professional Professional Modifier Low / Median / High Price $718.44 / $1,067.16 / $2,322.85	Professional		$718.44	$1,067.16	$2,322.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $119.18 / $368.13 / $586.54	Professional	26	$119.18	$368.13	$586.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $465.88 / $681.10 / $1,051.93	Professional	TC	$465.88	$681.10	$1,051.93