Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $741.31 / $776.25	Facility	26	$323.59	$741.31	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $602.56 / $1,862.09	Professional		$371.54	$602.56	$1,862.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $154.88 / $426.58	Professional	26	$102.33	$154.88	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $436.52 / $1,122.02	Professional	TC	$245.47	$436.52	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,174.90 / $1,513.56	Professional		$1,122.02	$1,174.90	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $338.84 / $380.19	Professional	26	$199.53	$338.84	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $794.33 / $1,174.90	Professional	TC	$794.33	$794.33	$1,174.90
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $616.60 / $741.31 / $776.25	Facility	26	$616.60	$741.31	$776.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $977.24 / $2,187.76	Professional		$602.56	$977.24	$2,187.76
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $302.00 / $691.83	Professional	26	$165.96	$302.00	$691.83
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $645.65 / $1,445.44	Professional	TC	$436.52	$645.65	$1,445.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,479.11 / $2,511.89	Professional		$1,380.38	$1,479.11	$2,511.89
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $407.38 / $691.83	Professional	26	$380.19	$407.38	$691.83
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,000.00 / $1,122.02 / $1,778.28	Professional	TC	$1,000.00	$1,122.02	$1,778.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $870.96 / $1,174.90	Professional		$602.56	$870.96	$1,174.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $331.13 / $354.81	Professional	26	$87.10	$331.13	$354.81
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $794.33 / $1,174.90	Professional	TC	$269.15	$794.33	$1,174.90
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,318.26 / $3,715.35	Professional		$933.25	$1,318.26	$3,715.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $380.19 / $741.31	Professional	26	$263.03	$380.19	$741.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $954.99 / $3,019.95	Professional	TC	$645.65	$954.99	$3,019.95