Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $319.19 / $571.66 / $699.19	Facility	26	$319.19	$571.66	$699.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $2,256.61	Professional		$475.00	$522.50	$2,256.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $625.71	Professional	26	$140.00	$154.00	$625.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,630.90	Professional	TC	$335.00	$368.50	$1,630.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $623.03 / $1,125.00 / $1,558.59	Professional		$623.03	$1,125.00	$1,558.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $155.51 / $337.50 / $357.00	Professional	26	$155.51	$337.50	$357.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $467.51 / $787.50 / $1,207.67	Professional	TC	$467.51	$787.50	$1,207.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $991.67 / $1,206.21 / $2,612.61	Professional		$991.67	$1,206.21	$2,612.61
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $246.65 / $301.25 / $740.47	Professional	26	$246.65	$301.25	$740.47
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $703.80 / $910.23 / $1,872.15	Professional	TC	$703.80	$910.23	$1,872.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,553.75 / $1,802.35 / $3,012.78	Professional		$1,553.75	$1,802.35	$3,012.78
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $381.25 / $427.00 / $688.50	Professional	26	$381.25	$427.00	$688.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,172.50 / $1,391.00 / $2,333.34	Professional	TC	$1,172.50	$1,391.00	$2,333.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $579.48 / $1,581.25 / $2,964.62	Professional		$579.48	$1,581.25	$2,964.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $329.19 / $456.00 / $679.44	Professional	26	$329.19	$456.00	$679.44
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1,051.84 / $1,566.00 / $2,333.34	Professional	TC	$1,051.84	$1,566.00	$2,333.34
United Facility/Professional Professional Modifier Low / Median / High Price $486.49 / $1,600.73 / $2,429.09	Professional		$486.49	$1,600.73	$2,429.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $147.04 / $452.43 / $640.94	Professional	26	$147.04	$452.43	$640.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $841.48 / $1,262.22 / $1,788.15	Professional	TC	$841.48	$1,262.22	$1,788.15