Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.01 / $531.79 / $531.79	Facility	26	$217.01	$531.79	$531.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,269.92	Professional		$475.00	$522.50	$1,269.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $425.44	Professional	26	$140.00	$154.00	$425.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $513.26 / $634.96 / $634.96	Professional	52	$513.26	$634.96	$634.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $844.48	Professional	TC	$335.00	$368.50	$844.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $347.68 / $864.10 / $900.00	Professional		$347.68	$864.10	$900.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.50 / $239.15 / $270.00	Professional	26	$104.50	$239.15	$270.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $243.19 / $624.94 / $630.00	Professional	TC	$243.19	$624.94	$630.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $561.20 / $673.44 / $1,549.00	Professional		$561.20	$673.44	$1,549.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $166.58 / $204.10 / $504.19	Professional	26	$166.58	$204.10	$504.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $366.19 / $473.55 / $973.61	Professional	TC	$366.19	$473.55	$973.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $867.50 / $1,066.00 / $1,794.00	Professional		$867.50	$1,066.00	$1,794.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $257.50 / $278.10 / $468.00	Professional	26	$257.50	$278.10	$468.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $610.00 / $832.33 / $1,378.00	Professional	TC	$610.00	$832.33	$1,378.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $327.77 / $900.00 / $1,674.02	Professional		$327.77	$900.00	$1,674.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $224.54 / $312.00 / $464.88	Professional	26	$224.54	$312.00	$464.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $626.25 / $831.30 / $1,378.00	Professional	TC	$626.25	$831.30	$1,378.00
United Facility/Professional Professional Modifier Low / Median / High Price $641.38 / $962.07 / $1,362.93	Professional		$641.38	$962.07	$1,362.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.40 / $307.77 / $436.60	Professional	26	$99.40	$307.77	$436.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $435.92 / $653.88 / $926.33	Professional	TC	$435.92	$653.88	$926.33