Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.02 / $265.02 / $265.02	Facility	26	$265.02	$265.02	$265.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,501.70	Professional		$475.00	$522.50	$1,501.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $519.54	Professional	26	$140.00	$154.00	$519.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $982.16	Professional	TC	$335.00	$368.50	$982.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $413.40 / $1,014.17 / $1,055.00	Professional		$413.40	$1,014.17	$1,055.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.02 / $290.32 / $312.83	Professional	26	$129.02	$290.32	$312.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $284.37 / $717.50 / $738.50	Professional	TC	$284.37	$717.50	$738.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $665.53 / $798.63 / $1,830.00	Professional		$665.53	$798.63	$1,830.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $204.60 / $249.77 / $614.13	Professional	26	$204.60	$249.77	$614.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $427.48 / $553.14 / $1,134.32	Professional	TC	$427.48	$553.14	$1,134.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,028.75 / $1,180.40 / $1,953.39	Professional		$1,028.75	$1,180.40	$1,953.39
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $316.25 / $341.55 / $573.75	Professional	26	$316.25	$341.55	$573.75
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $712.50 / $828.10 / $1,387.94	Professional	TC	$712.50	$828.10	$1,387.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $387.82 / $1,043.75 / $1,917.30	Professional		$387.82	$1,043.75	$1,917.30
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $273.45 / $379.50 / $565.46	Professional	26	$273.45	$379.50	$565.46
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $711.60 / $931.50 / $1,387.94	Professional	TC	$711.60	$931.50	$1,387.94
United Facility/Professional Professional Modifier Low / Median / High Price $750.74 / $1,126.10 / $3,353.00	Professional		$750.74	$1,126.10	$3,353.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.32 / $375.42 / $1,079.00	Professional	26	$122.32	$375.42	$1,079.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $500.46 / $755.00 / $2,274.00	Professional	TC	$500.46	$755.00	$2,274.00