Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $266.79 / $266.79 / $266.79	Facility	26	$266.79	$266.79	$266.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,830.45	Professional		$475.00	$522.50	$1,830.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $523.01	Professional	26	$140.00	$154.00	$523.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,307.44	Professional	TC	$335.00	$368.50	$1,307.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $507.20 / $1,125.00 / $1,256.63	Professional		$507.20	$1,125.00	$1,256.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.54 / $292.60 / $337.50	Professional	26	$127.54	$292.60	$337.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $379.66 / $787.50 / $964.02	Professional	TC	$379.66	$787.50	$964.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $810.21 / $983.01 / $2,130.32	Professional		$810.21	$983.01	$2,130.32
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $203.78 / $250.61 / $617.32	Professional	26	$203.78	$250.61	$617.32
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $570.74 / $738.48 / $1,513.05	Professional	TC	$570.74	$738.48	$1,513.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,266.25 / $1,461.20 / $2,416.04	Professional		$1,266.25	$1,461.20	$2,416.04
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $315.00 / $340.20 / $567.69	Professional	26	$315.00	$340.20	$567.69
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $951.25 / $1,103.70 / $1,848.35	Professional	TC	$951.25	$1,103.70	$1,848.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $472.51 / $1,287.50 / $2,377.19	Professional		$472.51	$1,287.50	$2,377.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $276.51 / $381.00 / $567.69	Professional	26	$276.51	$381.00	$567.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $833.00 / $1,240.50 / $1,848.35	Professional	TC	$833.00	$1,240.50	$1,848.35
United Facility/Professional Professional Modifier Low / Median / High Price $839.41 / $955.38 / $2,446.16	Professional		$839.41	$955.38	$2,446.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.74 / $251.91 / $671.03	Professional	26	$123.74	$251.91	$671.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $666.37 / $704.72 / $1,775.13	Professional	TC	$666.37	$704.72	$1,775.13