Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.63 / $177.63 / $177.63	Facility	26	$177.63	$177.63	$177.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,242.61	Professional		$475.00	$522.50	$1,242.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $348.22	Professional	26	$140.00	$154.00	$348.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $894.40	Professional	TC	$335.00	$368.50	$894.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.91 / $848.86 / $1,055.00	Professional		$346.91	$848.86	$1,055.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.87 / $194.97 / $307.50	Professional	26	$84.87	$194.97	$307.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $262.04 / $653.89 / $738.50	Professional	TC	$262.04	$653.89	$738.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $553.24 / $672.48 / $1,704.00	Professional		$553.24	$672.48	$1,704.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.85 / $167.00 / $412.34	Professional	26	$135.85	$167.00	$412.34
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $393.67 / $509.46 / $1,034.99	Professional	TC	$393.67	$509.46	$1,034.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $866.25 / $1,071.68 / $1,671.52	Professional		$866.25	$1,071.68	$1,671.52
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $210.00 / $226.80 / $379.95	Professional	26	$210.00	$226.80	$379.95
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $656.25 / $849.80 / $1,266.30	Professional	TC	$656.25	$849.80	$1,266.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $321.02 / $1,011.40 / $1,616.24	Professional		$321.02	$1,011.40	$1,616.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $183.44 / $255.00 / $379.95	Professional	26	$183.44	$255.00	$379.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $666.25 / $849.80 / $1,498.00	Professional	TC	$666.25	$849.80	$1,498.00
United Facility/Professional Professional Modifier Low / Median / High Price $612.26 / $765.33 / $1,630.97	Professional		$612.26	$765.33	$1,630.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.47 / $175.11 / $448.33	Professional	26	$81.47	$175.11	$448.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $443.96 / $663.23 / $1,182.64	Professional	TC	$443.96	$663.23	$1,182.64