Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.02 / $265.02 / $265.02	Facility	26	$265.02	$265.02	$265.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,500.20	Professional		$475.00	$522.50	$1,500.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $519.54	Professional	26	$140.00	$154.00	$519.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $599.53 / $750.10 / $750.10	Professional	52	$599.53	$750.10	$750.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $980.66	Professional	TC	$335.00	$368.50	$980.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $412.93 / $1,009.34 / $1,055.00	Professional		$412.93	$1,009.34	$1,055.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.07 / $290.32 / $312.83	Professional	26	$127.07	$290.32	$312.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $285.86 / $717.50 / $738.50	Professional	TC	$285.86	$717.50	$738.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $666.35 / $799.62 / $1,747.41	Professional		$666.35	$799.62	$1,747.41
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $202.98 / $248.92 / $613.09	Professional	26	$202.98	$248.92	$613.09
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $429.76 / $556.04 / $1,134.32	Professional	TC	$429.76	$556.04	$1,134.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,030.00 / $1,175.20 / $1,942.22	Professional		$1,030.00	$1,175.20	$1,942.22
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $313.75 / $338.85 / $571.50	Professional	26	$313.75	$338.85	$571.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $716.25 / $830.85 / $1,382.08	Professional	TC	$716.25	$830.85	$1,382.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $387.58 / $1,042.50 / $1,906.80	Professional		$387.58	$1,042.50	$1,906.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $273.45 / $379.50 / $565.46	Professional	26	$273.45	$379.50	$565.46
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $711.60 / $924.00 / $1,376.76	Professional	TC	$711.60	$924.00	$1,376.76
United Facility/Professional Professional Modifier Low / Median / High Price $746.70 / $1,120.05 / $1,586.74	Professional		$746.70	$1,120.05	$1,586.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $121.74 / $375.42 / $531.85	Professional	26	$121.74	$375.42	$531.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $496.42 / $748.90 / $1,054.89	Professional	TC	$496.42	$748.90	$1,054.89