Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $436.52 / $537.03	Facility	26	$223.87	$436.52	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $602.56 / $1,096.48	Professional		$208.93	$602.56	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $141.25 / $295.12	Professional	26	$70.79	$141.25	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $338.84 / $616.60	Professional	TC	$134.90	$338.84	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $891.25 / $1,023.29	Professional		$660.69	$891.25	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $263.03 / $269.15	Professional	26	$138.04	$263.03	$269.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $630.96 / $776.25	Professional	TC	$407.38	$630.96	$776.25
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $436.52 / $1,000.00	Facility	26	$93.33	$436.52	$1,000.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $575.44 / $1,258.93	Professional		$426.58	$575.44	$1,258.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $208.93 / $512.86	Professional	26	$114.82	$208.93	$512.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $354.81 / $741.31	Professional	TC	$263.03	$354.81	$741.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $831.76 / $1,380.38	Professional		$724.44	$831.76	$1,380.38
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $281.84 / $478.63	Professional	26	$263.03	$281.84	$478.63
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $537.03 / $891.25	Professional	TC	$478.63	$537.03	$891.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $489.78 / $891.25	Professional		$338.84	$489.78	$891.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $239.88 / $269.15	Professional	26	$58.88	$239.88	$269.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $407.38 / $776.25	Professional	TC	$134.90	$407.38	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $758.58 / $2,454.71	Professional		$537.03	$758.58	$2,454.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $263.03 / $660.69	Professional	26	$181.97	$263.03	$660.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $478.63 / $1,778.28	Professional	TC	$323.59	$478.63	$1,778.28