Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $241.41 / $461.30 / $591.54	Facility	26	$241.41	$461.30	$591.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $533.05 / $1,720.80	Professional		$475.00	$533.05	$1,720.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $473.24	Professional	26	$140.00	$154.00	$473.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,247.56	Professional	TC	$335.00	$368.50	$1,247.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $472.63 / $1,025.00 / $1,189.75	Professional		$472.63	$1,025.00	$1,189.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.79 / $266.88 / $307.50	Professional	26	$115.79	$266.88	$307.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $356.84 / $717.50 / $922.87	Professional	TC	$356.84	$717.50	$922.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $754.24 / $917.01 / $1,995.13	Professional		$754.24	$917.01	$1,995.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $185.18 / $227.07 / $561.00	Professional	26	$185.18	$227.07	$561.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $537.26 / $694.80 / $1,434.13	Professional	TC	$537.26	$694.80	$1,434.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,181.25 / $1,370.25 / $2,299.82	Professional		$1,181.25	$1,370.25	$2,299.82
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $286.25 / $309.14 / $522.00	Professional	26	$286.25	$309.14	$522.00
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $895.00 / $1,059.50 / $1,781.30	Professional	TC	$895.00	$1,059.50	$1,781.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $442.52 / $1,208.75 / $2,257.50	Professional		$442.52	$1,208.75	$2,257.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $248.74 / $348.00 / $518.52	Professional	26	$248.74	$348.00	$518.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $803.11 / $1,195.50 / $1,781.30	Professional	TC	$803.11	$1,195.50	$1,781.30
United Facility/Professional Professional Modifier Low / Median / High Price $855.32 / $1,307.09 / $1,885.00	Professional		$855.32	$1,307.09	$1,885.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.28 / $286.14 / $474.75	Professional	26	$110.28	$286.14	$474.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $642.48 / $963.72 / $1,413.75	Professional	TC	$642.48	$963.72	$1,413.75