Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $318.35 / $746.24 / $780.06	Facility	26	$318.35	$746.24	$780.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,880.07	Professional		$475.00	$522.50	$1,880.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $624.04	Professional	26	$140.00	$154.00	$624.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,256.01	Professional	TC	$335.00	$368.50	$1,256.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $517.32 / $1,125.00 / $1,273.93	Professional		$517.32	$1,125.00	$1,273.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $155.02 / $337.50 / $357.00	Professional	26	$155.02	$337.50	$357.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $362.30 / $787.50 / $925.43	Professional	TC	$362.30	$787.50	$925.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $832.63 / $1,000.47 / $2,184.33	Professional		$832.63	$1,000.47	$2,184.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $245.83 / $300.47 / $738.54	Professional	26	$245.83	$300.47	$738.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $545.52 / $705.48 / $1,445.79	Professional	TC	$545.52	$705.48	$1,445.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.75 / $1,494.95 / $2,486.77	Professional		$1,288.75	$1,494.95	$2,486.77
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $380.00 / $425.60 / $684.00	Professional	26	$380.00	$425.60	$684.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $908.75 / $1,121.00 / $1,772.36	Professional	TC	$908.75	$1,121.00	$1,772.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $484.49 / $1,306.25 / $2,428.90	Professional		$484.49	$1,306.25	$2,428.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $328.34 / $454.50 / $677.21	Professional	26	$328.34	$454.50	$677.21
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $833.00 / $1,189.50 / $1,772.36	Professional	TC	$833.00	$1,189.50	$1,772.36
United Facility/Professional Professional Modifier Low / Median / High Price $940.08 / $975.20 / $1,949.59	Professional		$940.08	$975.20	$1,949.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $143.80 / $450.36 / $639.24	Professional	26	$143.80	$450.36	$639.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $639.26 / $964.39 / $1,453.69	Professional	TC	$639.26	$964.39	$1,453.69