Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $340.02 / $694.01 / $833.22	Facility	26	$340.02	$694.01	$833.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,789.89	Professional		$475.00	$522.50	$1,789.89
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 / $1,123.31	Professional	TC	$335.00	$368.50	$1,123.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $490.39 / $1,119.58 / $1,410.23	Professional		$490.39	$1,119.58	$1,410.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.81 / $372.70 / $402.22	Professional	26	$165.81	$372.70	$402.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $324.58 / $717.37 / $1,016.07	Professional	TC	$324.58	$717.37	$1,016.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $789.25 / $947.10 / $2,085.00	Professional		$789.25	$947.10	$2,085.00
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 $488.39 / $631.74 / $1,295.85	Professional	TC	$488.39	$631.74	$1,295.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,220.00 / $1,397.50 / $2,317.69	Professional		$1,220.00	$1,397.50	$2,317.69
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 $813.75 / $949.00 / $1,591.32	Professional	TC	$813.75	$949.00	$1,591.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $462.46 / $1,236.25 / $2,265.90	Professional		$462.46	$1,236.25	$2,265.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $388.80 / $487.50 / $726.38	Professional	26	$388.80	$487.50	$726.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $814.80 / $1,068.00 / $1,591.32	Professional	TC	$814.80	$1,068.00	$1,591.32
United Facility/Professional Professional Modifier Low / Median / High Price $895.68 / $1,308.47 / $1,857.51	Professional		$895.68	$1,308.47	$1,857.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $174.86 / $482.67 / $683.78	Professional	26	$174.86	$482.67	$683.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $573.90 / $865.79 / $1,473.48	Professional	TC	$573.90	$865.79	$1,473.48