Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $201.33 / $383.77 / $493.33	Facility	26	$201.33	$383.77	$493.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,536.23	Professional		$475.00	$522.50	$1,536.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $394.67	Professional	26	$140.00	$154.00	$394.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,141.56	Professional	TC	$335.00	$368.50	$1,141.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.96 / $900.00 / $1,153.38	Professional		$457.96	$900.00	$1,153.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.65 / $222.07 / $270.00	Professional	26	$96.65	$222.07	$270.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $361.31 / $630.00 / $931.31	Professional	TC	$361.31	$630.00	$931.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $724.92 / $888.87 / $1,917.19	Professional		$724.92	$888.87	$1,917.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $154.44 / $189.29 / $467.56	Professional	26	$154.44	$189.29	$467.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $544.01 / $703.53 / $1,449.69	Professional	TC	$544.01	$703.53	$1,449.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,145.00 / $1,328.20 / $2,219.36	Professional		$1,145.00	$1,328.20	$2,219.36
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $238.75 / $257.85 / $434.25	Professional	26	$238.75	$257.85	$434.25
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $906.25 / $1,064.70 / $1,790.24	Professional	TC	$906.25	$1,064.70	$1,790.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $425.24 / $1,171.25 / $2,181.90	Professional		$425.24	$1,171.25	$2,181.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $207.29 / $288.00 / $429.12	Professional	26	$207.29	$288.00	$429.12
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $807.15 / $1,201.50 / $1,790.24	Professional	TC	$807.15	$1,201.50	$1,790.24
United Facility/Professional Professional Modifier Low / Median / High Price $784.76 / $1,253.84 / $1,776.29	Professional		$784.76	$1,253.84	$1,776.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.89 / $285.12 / $404.13	Professional	26	$91.89	$285.12	$404.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $645.72 / $968.58 / $1,372.16	Professional	TC	$645.72	$968.58	$1,372.16