Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.71 / $335.64 / $335.64	Facility	26	$188.71	$335.64	$335.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.70 / $383.66 / $792.38	Professional		$335.70	$383.66	$792.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $92.28 / $268.52	Professional	26	$54.56	$92.28	$268.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.40 / $325.76 / $523.86	Professional	TC	$243.40	$325.76	$523.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.19 / $733.44 / $973.00	Professional		$300.19	$733.44	$973.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.26 / $207.41 / $276.00	Professional	26	$90.26	$207.41	$276.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.93 / $526.04 / $681.10	Professional	TC	$209.93	$526.04	$681.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $484.40 / $581.28 / $1,273.53	Professional		$484.40	$581.28	$1,273.53
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $143.94 / $176.65 / $436.21	Professional	26	$143.94	$176.65	$436.21
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $315.81 / $408.54 / $837.32	Professional	TC	$315.81	$408.54	$837.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $748.75 / $945.00 / $1,444.79	Professional		$748.75	$945.00	$1,444.79
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $222.50 / $240.30 / $400.07	Professional	26	$222.50	$240.30	$400.07
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $526.25 / $718.75 / $1,041.51	Professional	TC	$526.25	$718.75	$1,041.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $282.47 / $804.00 / $1,441.58	Professional		$282.47	$804.00	$1,441.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $193.49 / $268.50 / $400.07	Professional	26	$193.49	$268.50	$400.07
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $538.75 / $710.68 / $1,162.00	Professional	TC	$538.75	$710.68	$1,162.00
United Facility/Professional Professional Modifier Low / Median / High Price $553.20 / $829.80 / $2,026.00	Professional		$553.20	$829.80	$2,026.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.43 / $266.22 / $560.00	Professional	26	$85.43	$266.22	$560.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $375.71 / $524.16 / $1,466.00	Professional	TC	$375.71	$524.16	$1,466.00