Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $178.47 / $437.35 / $437.35	Facility	26	$178.47	$437.35	$437.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,182.75	Professional		$475.00	$522.50	$1,182.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $349.88	Professional	26	$140.00	$154.00	$349.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $832.87	Professional	TC	$335.00	$368.50	$832.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.53 / $806.64 / $900.00	Professional		$329.53	$806.64	$900.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.37 / $196.17 / $270.00	Professional	26	$85.37	$196.17	$270.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.17 / $610.47 / $630.00	Professional	TC	$244.17	$610.47	$630.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $526.91 / $638.52 / $1,562.00	Professional		$526.91	$638.52	$1,562.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $136.68 / $167.78 / $412.34	Professional	26	$136.68	$167.78	$412.34
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $366.60 / $474.51 / $966.85	Professional	TC	$366.60	$474.51	$966.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $822.50 / $1,089.41 / $1,587.10	Professional		$822.50	$1,089.41	$1,587.10
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $211.25 / $228.15 / $382.19	Professional	26	$211.25	$228.15	$382.19
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $611.25 / $855.75 / $1,222.00	Professional	TC	$611.25	$855.75	$1,222.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $305.89 / $900.00 / $1,548.86	Professional		$305.89	$900.00	$1,548.86
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $184.29 / $256.50 / $382.19	Professional	26	$184.29	$256.50	$382.19
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $622.50 / $819.89 / $1,522.00	Professional	TC	$622.50	$819.89	$1,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $589.67 / $589.67 / $1,561.56	Professional		$589.67	$589.67	$1,561.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.47 / $175.94 / $450.46	Professional	26	$81.47	$175.94	$450.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $420.58 / $611.41 / $1,120.35	Professional	TC	$420.58	$611.41	$1,120.35