Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $340.02 / $701.09 / $833.22	Facility	26	$340.02	$701.09	$833.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,884.80	Professional		$475.00	$522.50	$1,884.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $666.58	Professional	26	$140.00	$154.00	$666.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,120.00	Professional	TC	$335.00	$368.50	$1,120.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.40 / $1,125.00 / $1,197.86	Professional		$489.40	$1,125.00	$1,197.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.81 / $337.50 / $394.16	Professional	26	$165.81	$337.50	$394.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.58 / $787.50 / $833.00	Professional	TC	$323.58	$787.50	$833.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $787.63 / $945.15 / $2,081.09	Professional		$787.63	$945.15	$2,081.09
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $262.83 / $320.89 / $789.14	Professional	26	$262.83	$320.89	$789.14
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $486.89 / $629.79 / $1,292.01	Professional	TC	$486.89	$629.79	$1,292.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,217.50 / $1,394.90 / $2,313.23	Professional		$1,217.50	$1,394.90	$2,313.23
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $406.25 / $455.00 / $731.25	Professional	26	$406.25	$455.00	$731.25
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $811.25 / $945.10 / $1,586.85	Professional	TC	$811.25	$945.10	$1,586.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $461.59 / $1,233.75 / $2,261.69	Professional		$461.59	$1,233.75	$2,261.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $337.50 / $487.50 / $726.38	Professional	26	$337.50	$487.50	$726.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $787.50 / $1,065.00 / $1,586.85	Professional	TC	$787.50	$1,065.00	$1,586.85
United Facility/Professional Professional Modifier Low / Median / High Price $894.06 / $1,341.09 / $1,899.88	Professional		$894.06	$1,341.09	$1,899.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $175.44 / $481.05 / $683.78	Professional	26	$175.44	$481.05	$683.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $572.28 / $863.34 / $1,596.27	Professional	TC	$572.28	$863.34	$1,596.27