Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $338.84 / $338.84	Facility	26	$190.55	$338.84	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $794.33	Professional		$199.53	$281.84	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $251.19	Professional	26	$54.95	$74.13	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $213.80 / $524.81	Professional	TC	$138.04	$213.80	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $831.76 / $977.24	Professional		$691.83	$831.76	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $208.93 / $295.12	Professional	26	$117.49	$208.93	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $645.65 / $676.08	Professional	TC	$467.74	$645.65	$676.08
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Facility	26	$338.84	$338.84	$338.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $562.34 / $1,023.29	Professional		$398.11	$562.34	$1,023.29
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $177.83 / $338.84	Professional	26	$125.89	$177.83	$338.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $371.54 / $741.31	Professional	TC	$316.23	$371.54	$741.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $977.24 / $1,445.44	Professional		$812.83	$977.24	$1,445.44
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $239.88 / $398.11	Professional	26	$223.87	$239.88	$398.11
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $741.31 / $1,047.13	Professional	TC	$575.44	$741.31	$1,047.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $512.86 / $831.76	Professional		$346.74	$512.86	$831.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $194.98 / $295.12	Professional	26	$50.12	$194.98	$295.12
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $467.74 / $676.08	Professional	TC	$190.55	$467.74	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $831.76 / $2,754.23	Professional		$549.54	$831.76	$2,754.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $269.15 / $891.25	Professional	26	$154.88	$269.15	$891.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $562.34 / $1,862.09	Professional	TC	$371.54	$562.34	$1,862.09