Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $265.64 / $265.64 / $265.64	Facility	26	$265.64	$265.64	$265.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,851.41	Professional		$475.00	$522.50	$1,851.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $520.75	Professional	26	$140.00	$154.00	$520.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,330.66	Professional	TC	$335.00	$368.50	$1,330.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $516.61 / $1,152.54 / $1,262.70	Professional		$516.61	$1,152.54	$1,262.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.01 / $274.47 / $312.52	Professional	26	$129.01	$274.47	$312.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $387.60 / $840.02 / $972.47	Professional	TC	$387.60	$840.02	$972.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $822.03 / $999.51 / $2,154.90	Professional		$822.03	$999.51	$2,154.90
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $204.60 / $250.38 / $614.63	Professional	26	$204.60	$250.38	$614.63
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $582.78 / $753.99 / $1,540.28	Professional	TC	$582.78	$753.99	$1,540.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,287.50 / $1,472.90 / $2,427.21	Professional		$1,287.50	$1,472.90	$2,427.21
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $316.25 / $354.20 / $569.25	Professional	26	$316.25	$354.20	$569.25
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $971.25 / $1,126.65 / $1,863.99	Professional	TC	$971.25	$1,126.65	$1,863.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $477.96 / $1,303.75 / $2,383.50	Professional		$477.96	$1,303.75	$2,383.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $274.47 / $378.00 / $563.22	Professional	26	$274.47	$378.00	$563.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $964.80 / $1,251.00 / $1,863.99	Professional	TC	$964.80	$1,251.00	$1,863.99
United Facility/Professional Professional Modifier Low / Median / High Price $833.05 / $959.29 / $3,458.00	Professional		$833.05	$959.29	$3,458.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.70 / $260.13 / $902.00	Professional	26	$122.70	$260.13	$902.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $672.01 / $699.16 / $1,417.48	Professional	TC	$672.01	$699.16	$1,417.48