Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.95 / $265.95 / $265.95	Facility	26	$265.95	$265.95	$265.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $388.27 / $477.42 / $1,017.32	Professional		$388.27	$477.42	$1,017.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.34 / $91.56 / $378.42	Professional	26	$78.34	$91.56	$378.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $309.93 / $385.85 / $638.90	Professional	TC	$309.93	$385.85	$638.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $464.99 / $973.00 / $1,140.69	Professional		$464.99	$973.00	$1,140.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.00 / $276.00 / $291.89	Professional	26	$129.00	$276.00	$291.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $335.99 / $658.87 / $849.29	Professional	TC	$335.99	$658.87	$849.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $745.23 / $899.55 / $1,949.31	Professional		$745.23	$899.55	$1,949.31
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $204.60 / $250.67 / $616.44	Professional	26	$204.60	$250.67	$616.44
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $505.68 / $654.05 / $1,332.87	Professional	TC	$505.68	$654.05	$1,332.87
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,106.25 / $1,264.95 / $2,029.38	Professional		$1,106.25	$1,264.95	$2,029.38
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $316.25 / $341.55 / $567.69	Professional	26	$316.25	$341.55	$567.69
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $787.80 / $926.10 / $1,461.69	Professional	TC	$787.80	$926.10	$1,461.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $432.36 / $1,123.20 / $1,849.40	Professional		$432.36	$1,123.20	$1,849.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $276.00 / $381.00 / $567.69	Professional	26	$276.00	$381.00	$567.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $681.10 / $981.00 / $1,449.42	Professional	TC	$681.10	$981.00	$1,449.42
United Facility/Professional Professional Modifier Low / Median / High Price $741.74 / $825.73 / $2,586.00	Professional		$741.74	$825.73	$2,586.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.74 / $377.85 / $881.00	Professional	26	$123.74	$377.85	$881.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $527.09 / $733.77 / $1,705.00	Professional	TC	$527.09	$733.77	$1,705.00