Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $340.02 / $660.30 / $833.22	Facility	26	$340.02	$660.30	$833.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,783.26	Professional		$475.00	$522.50	$1,783.26
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 / $1,116.68	Professional	TC	$335.00	$368.50	$1,116.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $488.41 / $1,125.00 / $1,194.25	Professional		$488.41	$1,125.00	$1,194.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.81 / $337.50 / $372.70	Professional	26	$165.81	$337.50	$372.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $322.58 / $787.50 / $833.00	Professional	TC	$322.58	$787.50	$833.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $786.03 / $943.23 / $2,077.19	Professional		$786.03	$943.23	$2,077.19
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 $485.38 / $627.84 / $1,288.09	Professional	TC	$485.38	$627.84	$1,288.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,215.00 / $1,389.70 / $2,308.76	Professional		$1,215.00	$1,389.70	$2,308.76
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $406.25 / $455.00 / $733.50	Professional	26	$406.25	$455.00	$733.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $808.75 / $942.50 / $1,582.38	Professional	TC	$808.75	$942.50	$1,582.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $460.73 / $1,231.25 / $2,257.50	Professional		$460.73	$1,231.25	$2,257.50
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 / $1,062.00 / $1,582.38	Professional	TC	$787.50	$1,062.00	$1,582.38
United Facility/Professional Professional Modifier Low / Median / High Price $892.44 / $1,346.34 / $1,896.44	Professional		$892.44	$1,346.34	$1,896.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $161.03 / $402.23 / $683.79	Professional	26	$161.03	$402.23	$683.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $570.66 / $860.90 / $1,473.48	Professional	TC	$570.66	$860.90	$1,473.48