Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $180.78 / $180.78 / $180.78	Facility	26	$180.78	$180.78	$180.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $343.39 / $423.46 / $897.89	Professional		$343.39	$423.46	$897.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $61.24 / $257.24	Professional	26	$52.46	$61.24	$257.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.93 / $362.21 / $640.65	Professional	TC	$290.93	$362.21	$640.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.66 / $920.00 / $973.00	Professional		$380.66	$920.00	$973.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.34 / $198.50 / $276.00	Professional	26	$86.34	$198.50	$276.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $294.31 / $644.00 / $758.83	Professional	TC	$294.31	$644.00	$758.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $606.02 / $739.44 / $1,599.62	Professional		$606.02	$739.44	$1,599.62
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $138.28 / $169.97 / $417.73	Professional	26	$138.28	$169.97	$417.73
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $443.63 / $573.51 / $1,181.90	Professional	TC	$443.63	$573.51	$1,181.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $935.00 / $1,050.30 / $1,712.01	Professional		$935.00	$1,050.30	$1,712.01
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $213.75 / $230.85 / $386.66	Professional	26	$213.75	$230.85	$386.66
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $718.75 / $820.80 / $1,325.36	Professional	TC	$718.75	$820.80	$1,325.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $354.80 / $951.60 / $1,549.87	Professional		$354.80	$951.60	$1,549.87
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $186.67 / $259.50 / $386.66	Professional	26	$186.67	$259.50	$386.66
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $644.00 / $889.50 / $1,325.36	Professional	TC	$644.00	$889.50	$1,325.36
United Facility/Professional Professional Modifier Low / Median / High Price $586.84 / $934.80 / $2,123.00	Professional		$586.84	$934.80	$2,123.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.00 / $256.89 / $584.00	Professional	26	$83.00	$256.89	$584.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $477.87 / $677.52 / $1,539.00	Professional	TC	$477.87	$677.52	$1,539.00