Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $220.17 / $436.95 / $539.52	Facility	26	$220.17	$436.95	$539.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,067.08	Professional		$475.00	$522.50	$1,067.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.44 / $154.00 / $431.62	Professional	26	$108.44	$154.00	$431.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $635.47	Professional	TC	$335.00	$368.50	$635.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.58 / $709.62 / $900.00	Professional		$291.58	$709.62	$900.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.97 / $245.50 / $270.00	Professional	26	$105.97	$245.50	$270.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.61 / $468.14 / $630.00	Professional	TC	$185.61	$468.14	$630.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $469.83 / $565.55 / $1,472.12	Professional		$469.83	$565.55	$1,472.12
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $169.00 / $207.07 / $509.58	Professional	26	$169.00	$207.07	$509.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $278.98 / $360.99 / $736.07	Professional	TC	$278.98	$360.99	$736.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $726.25 / $825.50 / $1,365.59	Professional		$726.25	$825.50	$1,365.59
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $261.25 / $282.14 / $477.00	Professional	26	$261.25	$282.14	$477.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $465.00 / $539.40 / $897.26	Professional	TC	$465.00	$539.40	$897.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $276.29 / $778.75 / $1,339.80	Professional		$276.29	$778.75	$1,339.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $245.50 / $316.50 / $471.59	Professional	26	$245.50	$316.50	$471.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $473.75 / $625.91 / $894.00	Professional	TC	$473.75	$625.91	$894.00
United Facility/Professional Professional Modifier Low / Median / High Price $530.90 / $796.35 / $1,128.16	Professional		$530.90	$796.35	$1,128.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.33 / $312.66 / $442.94	Professional	26	$109.33	$312.66	$442.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $322.45 / $483.69 / $736.39	Professional	TC	$322.45	$483.69	$736.39