Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $549.54 / $1,230.27	Professional		$281.84	$549.54	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.03 / $354.81	Professional	26	$85.11	$123.03	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $371.54 / $891.25	Professional	TC	$204.17	$371.54	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,023.29 / $1,258.93	Professional		$933.25	$1,023.29	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $309.03 / $316.23	Professional	26	$165.96	$309.03	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $724.44 / $977.24	Professional	TC	$630.96	$724.44	$977.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $776.25 / $1,737.80	Professional		$660.69	$776.25	$1,737.80
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $251.19 / $524.81	Professional	26	$190.55	$251.19	$524.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $537.03 / $1,122.02	Professional	TC	$426.58	$537.03	$1,122.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,174.90 / $1,949.84	Professional		$1,023.29	$1,174.90	$1,949.84
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $338.84 / $575.44	Professional	26	$316.23	$338.84	$575.44
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $831.76 / $1,380.38	Professional	TC	$707.95	$831.76	$1,380.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $691.83 / $1,023.29	Professional		$478.63	$691.83	$1,023.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $275.42 / $316.23	Professional	26	$72.44	$275.42	$316.23
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $630.96 / $977.24	Professional	TC	$213.80	$630.96	$977.24
United Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $933.25 / $3,388.44	Professional		$758.58	$933.25	$3,388.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $316.23 / $1,071.52	Professional	26	$218.78	$316.23	$1,071.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $758.58 / $2,344.23	Professional	TC	$501.19	$758.58	$2,344.23