Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.86 / $651.50 / $651.50	Facility	26	$265.86	$651.50	$651.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,526.58	Professional		$475.00	$522.50	$1,526.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $521.20	Professional	26	$140.00	$154.00	$521.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,005.38	Professional	TC	$335.00	$368.50	$1,005.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $420.84 / $952.54 / $1,305.39	Professional		$420.84	$952.54	$1,305.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.52 / $291.52 / $313.85	Professional	26	$129.52	$291.52	$313.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $291.32 / $638.69 / $1,010.13	Professional	TC	$291.32	$638.69	$1,010.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $677.44 / $813.18 / $1,830.00	Professional		$677.44	$813.18	$1,830.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $205.40 / $250.56 / $616.11	Professional	26	$205.40	$250.56	$616.11
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $438.02 / $566.70 / $1,161.55	Professional	TC	$438.02	$566.70	$1,161.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.50 / $1,193.40 / $1,984.68	Professional		$1,047.50	$1,193.40	$1,984.68
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $317.50 / $342.90 / $573.75	Professional	26	$317.50	$342.90	$573.75
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $730.00 / $846.80 / $1,416.99	Professional	TC	$730.00	$846.80	$1,416.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $394.28 / $1,062.50 / $1,942.50	Professional		$394.28	$1,062.50	$1,942.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $295.26 / $381.00 / $567.69	Professional	26	$295.26	$381.00	$567.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $728.40 / $951.00 / $1,416.99	Professional	TC	$728.40	$951.00	$1,416.99
United Facility/Professional Professional Modifier Low / Median / High Price $739.77 / $762.04 / $3,364.00	Professional		$739.77	$762.04	$3,364.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $131.68 / $376.62 / $1,070.00	Professional	26	$131.68	$376.62	$1,070.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $510.96 / $766.44 / $2,294.00	Professional	TC	$510.96	$766.44	$2,294.00