Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $219.33 / $537.44 / $537.44	Facility	26	$219.33	$537.44	$537.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,787.16	Professional		$475.00	$522.50	$1,787.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $429.96	Professional	26	$140.00	$154.00	$429.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,357.20	Professional	TC	$335.00	$368.50	$1,357.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $502.50 / $1,125.00 / $1,233.25	Professional		$502.50	$1,125.00	$1,233.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.47 / $260.55 / $337.50	Professional	26	$105.47	$260.55	$337.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $397.03 / $787.50 / $991.77	Professional	TC	$397.03	$787.50	$991.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $794.17 / $974.28 / $2,082.96	Professional		$794.17	$974.28	$2,082.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $168.20 / $206.28 / $509.58	Professional	26	$168.20	$206.28	$509.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $597.05 / $772.44 / $1,573.39	Professional	TC	$597.05	$772.44	$1,573.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,255.00 / $1,610.00 / $2,421.65	Professional		$1,255.00	$1,610.00	$2,421.65
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $260.00 / $294.00 / $471.59	Professional	26	$260.00	$294.00	$471.59
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $995.00 / $1,316.00 / $1,919.95	Professional	TC	$995.00	$1,316.00	$1,919.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $462.00 / $1,272.50 / $2,344.91	Professional		$462.00	$1,272.50	$2,344.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $253.15 / $316.50 / $471.59	Professional	26	$253.15	$316.50	$471.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $841.03 / $1,316.00 / $2,320.00	Professional	TC	$841.03	$1,316.00	$2,320.00
United Facility/Professional Professional Modifier Low / Median / High Price $881.26 / $1,139.35 / $4,640.00	Professional		$881.26	$1,139.35	$4,640.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.70 / $216.87 / $844.00	Professional	26	$122.70	$216.87	$844.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $672.82 / $932.02 / $3,796.00	Professional	TC	$672.82	$932.02	$3,796.00