Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $222.48 / $545.16 / $545.16	Facility	26	$222.48	$545.16	$545.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,355.43	Professional		$475.00	$522.50	$1,355.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $436.14	Professional	26	$140.00	$154.00	$436.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $919.28	Professional	TC	$335.00	$368.50	$919.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $375.93 / $918.20 / $1,055.00	Professional		$375.93	$918.20	$1,055.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.95 / $245.01 / $307.50	Professional	26	$106.95	$245.01	$307.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $268.98 / $673.19 / $738.50	Professional	TC	$268.98	$673.19	$738.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $604.15 / $727.80 / $1,704.00	Professional		$604.15	$727.80	$1,704.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $170.63 / $209.25 / $516.95	Professional	26	$170.63	$209.25	$516.95
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $404.18 / $523.04 / $1,064.20	Professional	TC	$404.18	$523.04	$1,064.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $937.50 / $1,156.50 / $1,809.00	Professional		$937.50	$1,156.50	$1,809.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $263.75 / $284.85 / $476.06	Professional	26	$263.75	$284.85	$476.06
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $673.75 / $912.80 / $1,300.07	Professional	TC	$673.75	$912.80	$1,300.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $350.70 / $1,025.00 / $1,750.17	Professional		$350.70	$1,025.00	$1,750.17
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $184.29 / $319.50 / $476.06	Professional	26	$184.29	$319.50	$476.06
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $685.00 / $906.28 / $1,610.00	Professional	TC	$685.00	$906.28	$1,610.00
United Facility/Professional Professional Modifier Low / Median / High Price $662.64 / $828.30 / $1,765.18	Professional		$662.64	$828.30	$1,765.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.47 / $210.82 / $561.01	Professional	26	$81.47	$210.82	$561.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $452.04 / $678.06 / $1,204.17	Professional	TC	$452.04	$678.06	$1,204.17