Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.01 / $217.01 / $217.01	Facility	26	$217.01	$217.01	$217.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,566.09	Professional		$475.00	$522.50	$1,566.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $425.44	Professional	26	$140.00	$154.00	$425.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,140.65	Professional	TC	$335.00	$368.50	$1,140.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $509.48 / $900.00 / $1,287.60	Professional		$509.48	$900.00	$1,287.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.50 / $237.95 / $270.00	Professional	26	$104.50	$237.95	$270.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $404.99 / $630.00 / $1,049.66	Professional	TC	$404.99	$630.00	$1,049.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $805.20 / $988.83 / $2,131.03	Professional		$805.20	$988.83	$2,131.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $166.58 / $204.10 / $502.21	Professional	26	$166.58	$204.10	$502.21
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $610.19 / $788.94 / $1,628.77	Professional	TC	$610.19	$788.94	$1,628.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,273.75 / $1,483.30 / $2,494.26	Professional		$1,273.75	$1,483.30	$2,494.26
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $257.50 / $278.10 / $468.00	Professional	26	$257.50	$278.10	$468.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,016.25 / $1,214.20 / $2,029.38	Professional	TC	$1,016.25	$1,214.20	$2,029.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $472.66 / $1,303.75 / $2,447.06	Professional		$472.66	$1,303.75	$2,447.06
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $222.64 / $312.00 / $464.88	Professional	26	$222.64	$312.00	$464.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $915.08 / $1,362.00 / $2,029.38	Professional	TC	$915.08	$1,362.00	$2,029.38
United Facility/Professional Professional Modifier Low / Median / High Price $819.79 / $975.40 / $1,944.28	Professional		$819.79	$975.40	$1,944.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.40 / $307.77 / $436.60	Professional	26	$99.40	$307.77	$436.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $732.05 / $1,098.08 / $1,555.63	Professional	TC	$732.05	$1,098.08	$1,555.63