Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $325.79 / $675.21 / $798.34	Facility	26	$325.79	$675.21	$798.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,874.79	Professional		$475.00	$522.50	$1,874.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $638.67	Professional	26	$140.00	$154.00	$638.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,236.10	Professional	TC	$335.00	$368.50	$1,236.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $513.79 / $1,125.00 / $1,271.30	Professional		$513.79	$1,125.00	$1,271.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.44 / $337.50 / $357.94	Professional	26	$158.44	$337.50	$357.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $355.35 / $787.50 / $913.37	Professional	TC	$355.35	$787.50	$913.37
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $828.08 / $993.69 / $2,176.41	Professional		$828.08	$993.69	$2,176.41
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $251.50 / $307.49 / $755.92	Professional	26	$251.50	$307.49	$755.92
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $535.01 / $691.89 / $1,420.49	Professional	TC	$535.01	$691.89	$1,420.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,280.00 / $1,484.80 / $2,469.89	Professional		$1,280.00	$1,484.80	$2,469.89
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $388.75 / $419.90 / $704.25	Professional	26	$388.75	$419.90	$704.25
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $1,135.40 / $1,788.00	Professional	TC	$891.25	$1,135.40	$1,788.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $482.74 / $1,298.75 / $2,456.27	Professional		$482.74	$1,298.75	$2,456.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $337.50 / $465.00 / $692.85	Professional	26	$337.50	$465.00	$692.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $833.00 / $1,183.50 / $1,788.00	Professional	TC	$833.00	$1,183.50	$1,788.00
United Facility/Professional Professional Modifier Low / Median / High Price $943.88 / $1,415.82 / $2,005.75	Professional		$943.88	$1,415.82	$2,005.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $154.00 / $461.76 / $654.16	Professional	26	$154.00	$461.76	$654.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $636.04 / $954.06 / $1,457.05	Professional	TC	$636.04	$954.06	$1,457.05