Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.62 / $199.62 / $199.62	Facility	26	$199.62	$199.62	$199.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,249.09	Professional		$475.00	$522.50	$1,249.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $391.35	Professional	26	$140.00	$154.00	$391.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $857.75	Professional	TC	$335.00	$368.50	$857.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $343.81 / $783.62 / $1,076.99	Professional		$343.81	$783.62	$1,076.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.66 / $206.11 / $235.71	Professional	26	$95.66	$206.11	$235.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $248.15 / $547.91 / $870.87	Professional	TC	$248.15	$547.91	$870.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $553.09 / $666.66 / $1,704.00	Professional		$553.09	$666.66	$1,704.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $152.83 / $187.72 / $463.65	Professional	26	$152.83	$187.72	$463.65
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $373.71 / $483.27 / $989.18	Professional	TC	$373.71	$483.27	$989.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $858.75 / $1,019.00 / $1,640.49	Professional		$858.75	$1,019.00	$1,640.49
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $236.25 / $255.15 / $424.65	Professional	26	$236.25	$255.15	$424.65
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $622.50 / $786.00 / $1,215.83	Professional	TC	$622.50	$786.00	$1,215.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $322.24 / $935.00 / $1,612.80	Professional		$322.24	$935.00	$1,612.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $206.11 / $285.00 / $424.65	Professional	26	$206.11	$285.00	$424.65
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $636.25 / $827.00 / $1,215.83	Professional	TC	$636.25	$827.00	$1,215.83
United Facility/Professional Professional Modifier Low / Median / High Price $626.90 / $940.35 / $1,699.00	Professional		$626.90	$940.35	$1,699.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.89 / $282.83 / $493.00	Professional	26	$91.89	$282.83	$493.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $438.34 / $657.51 / $1,206.00	Professional	TC	$438.34	$657.51	$1,206.00