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 / $556.04	Facility	26	$259.87	$462.21	$556.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.88 / $474.59 / $1,008.68	Professional		$385.88	$474.59	$1,008.68
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 $421.39 / $897.04 / $1,368.63	Professional		$421.39	$897.04	$1,368.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.61 / $267.64 / $306.76	Professional	26	$124.61	$267.64	$306.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $296.77 / $590.28 / $1,100.98	Professional	TC	$296.77	$590.28	$1,100.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $679.51 / $816.09 / $1,772.38	Professional		$679.51	$816.09	$1,772.38
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 $446.30 / $577.38 / $1,171.28	Professional	TC	$446.30	$577.38	$1,171.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,051.25 / $1,160.59 / $1,863.99	Professional		$1,051.25	$1,160.59	$1,863.99
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 $743.75 / $814.05 / $1,309.71	Professional	TC	$743.75	$814.05	$1,309.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $393.12 / $1,060.00 / $1,736.70	Professional		$393.12	$1,060.00	$1,736.70
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 $725.00 / $916.50 / $1,309.71	Professional	TC	$725.00	$916.50	$1,309.71
United Facility/Professional Professional Modifier Low / Median / High Price $717.64 / $1,064.73 / $1,715.16	Professional		$717.64	$1,064.73	$1,715.16
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 $472.21 / $696.39 / $1,128.60	Professional	TC	$472.21	$696.39	$1,128.60