Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $220.17 / $469.23 / $539.52	Facility	26	$220.17	$469.23	$539.52
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $111.74 / $453.95 / $852.15	Facility	53	$111.74	$453.95	$852.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,445.78	Professional		$475.00	$522.50	$1,445.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.87 / $154.00 / $431.62	Professional	26	$107.87	$154.00	$431.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $432.17 / $547.65 / $547.65	Professional	52	$432.17	$547.65	$547.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $663.67	Professional	TC	$335.00	$368.50	$663.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.02 / $727.71 / $900.00	Professional		$300.02	$727.71	$900.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.47 / $241.48 / $270.00	Professional	26	$105.47	$241.48	$270.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.54 / $486.23 / $630.00	Professional	TC	$194.54	$486.23	$630.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $483.58 / $580.29 / $1,513.53	Professional		$483.58	$580.29	$1,513.53
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 $201.84 / $346.93 / $771.10	Professional	TC	$201.84	$346.93	$771.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $747.50 / $847.60 / $1,403.58	Professional		$747.50	$847.60	$1,403.58
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $260.00 / $280.80 / $477.00	Professional	26	$260.00	$280.80	$477.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $487.50 / $565.50 / $940.68	Professional	TC	$487.50	$565.50	$940.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $284.06 / $797.50 / $1,375.50	Professional		$284.06	$797.50	$1,375.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $226.73 / $316.50 / $471.59	Professional	26	$226.73	$316.50	$471.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $481.20 / $630.00 / $932.00	Professional	TC	$481.20	$630.00	$932.00
United Facility/Professional Professional Modifier Low / Median / High Price $524.96 / $797.49 / $1,156.59	Professional		$524.96	$797.49	$1,156.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $101.34 / $312.66 / $442.94	Professional	26	$101.34	$312.66	$442.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $335.84 / $503.76 / $713.66	Professional	TC	$335.84	$503.76	$713.66