Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $340.02 / $739.50 / $833.22	Facility	26	$340.02	$739.50	$833.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $541.72 / $1,778.28	Professional		$475.00	$541.72	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $167.64 / $666.58	Professional	26	$140.00	$167.64	$666.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $706.51 / $889.14 / $889.14	Professional	52	$706.51	$889.14	$889.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,111.70	Professional	TC	$335.00	$368.50	$1,111.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $487.91 / $1,125.00 / $1,190.00	Professional		$487.91	$1,125.00	$1,190.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.32 / $337.50 / $372.70	Professional	26	$165.32	$337.50	$372.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $322.58 / $787.50 / $833.00	Professional	TC	$322.58	$787.50	$833.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $633.60 / $942.24 / $2,447.96	Professional		$633.60	$942.24	$2,447.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $262.00 / $320.11 / $787.16	Professional	26	$262.00	$320.11	$787.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $485.38 / $627.84 / $1,284.20	Professional	TC	$485.38	$627.84	$1,284.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,213.75 / $1,385.80 / $2,295.35	Professional		$1,213.75	$1,385.80	$2,295.35
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $405.00 / $437.40 / $731.25	Professional	26	$405.00	$437.40	$731.25
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $808.75 / $938.15 / $1,568.97	Professional	TC	$808.75	$938.15	$1,568.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $459.43 / $1,227.50 / $2,249.10	Professional		$459.43	$1,227.50	$2,249.10
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $337.50 / $487.50 / $726.38	Professional	26	$337.50	$487.50	$726.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $787.50 / $1,053.00 / $1,568.97	Professional	TC	$787.50	$1,053.00	$1,568.97
United Facility/Professional Professional Modifier Low / Median / High Price $887.60 / $1,339.04 / $1,886.15	Professional		$887.60	$1,339.04	$1,886.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $161.03 / $334.79 / $683.78	Professional	26	$161.03	$334.79	$683.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $565.82 / $853.60 / $1,473.48	Professional	TC	$565.82	$853.60	$1,473.48