Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.18 / $306.22 / $399.08	Facility	26	$172.18	$306.22	$399.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.55 / $329.25 / $884.43	Professional		$267.55	$329.25	$884.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $58.49 / $306.22	Professional	26	$50.07	$58.49	$306.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.46 / $270.75 / $639.45	Professional	TC	$217.46	$270.75	$639.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.97 / $784.00 / $868.72	Professional		$344.97	$784.00	$868.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.42 / $188.96 / $247.50	Professional	26	$82.42	$188.96	$247.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $262.55 / $553.29 / $679.75	Professional	TC	$262.55	$553.29	$679.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $550.14 / $669.57 / $1,452.99	Professional		$550.14	$669.57	$1,452.99
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.80 / $161.84 / $399.58	Professional	26	$131.80	$161.84	$399.58
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $395.51 / $511.41 / $1,053.42	Professional	TC	$395.51	$511.41	$1,053.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $823.75 / $951.75 / $1,522.04	Professional		$823.75	$951.75	$1,522.04
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $203.75 / $220.05 / $366.54	Professional	26	$203.75	$220.05	$366.54
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $616.25 / $731.70 / $1,155.50	Professional	TC	$616.25	$731.70	$1,155.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $322.27 / $829.40 / $1,404.93	Professional		$322.27	$829.40	$1,404.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $177.81 / $246.00 / $366.54	Professional	26	$177.81	$246.00	$366.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $553.29 / $775.50 / $1,125.74	Professional	TC	$553.29	$775.50	$1,125.74
United Facility/Professional Professional Modifier Low / Median / High Price $484.12 / $869.31 / $1,385.10	Professional		$484.12	$869.31	$1,385.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $244.02 / $388.81	Professional	26	$79.00	$244.02	$388.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $389.99 / $625.29 / $996.29	Professional	TC	$389.99	$625.29	$996.29