Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $267.33 / $655.08 / $655.08	Facility	26	$267.33	$655.08	$655.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,887.90	Professional		$475.00	$522.50	$1,887.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $524.07	Professional	26	$140.00	$154.00	$524.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,363.84	Professional	TC	$335.00	$368.50	$1,363.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $526.55 / $1,125.00 / $1,291.65	Professional		$526.55	$1,125.00	$1,291.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.04 / $293.85 / $337.50	Professional	26	$128.04	$293.85	$337.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $398.52 / $787.50 / $997.80	Professional	TC	$398.52	$787.50	$997.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $839.23 / $1,020.87 / $2,199.67	Professional		$839.23	$1,020.87	$2,199.67
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $204.60 / $279.00 / $730.93	Professional	26	$204.60	$279.00	$730.93
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $599.30 / $775.35 / $1,581.20	Professional	TC	$599.30	$775.35	$1,581.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,315.00 / $1,667.61 / $2,537.42	Professional		$1,315.00	$1,667.61	$2,537.42
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $316.25 / $341.55 / $572.16	Professional	26	$316.25	$341.55	$572.16
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $998.75 / $1,324.40 / $1,927.19	Professional	TC	$998.75	$1,324.40	$1,927.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $487.90 / $1,332.50 / $2,458.41	Professional		$487.90	$1,332.50	$2,458.41
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $275.32 / $384.00 / $572.16	Professional	26	$275.32	$384.00	$572.16
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $847.08 / $1,324.40 / $2,336.00	Professional	TC	$847.08	$1,324.40	$2,336.00
United Facility/Professional Professional Modifier Low / Median / High Price $930.92 / $1,368.41 / $2,167.00	Professional		$930.92	$1,368.41	$2,167.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.70 / $263.48 / $474.83	Professional	26	$122.70	$263.48	$474.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $677.68 / $847.10 / $1,707.00	Professional	TC	$677.68	$847.10	$1,707.00