Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $320.02 / $320.02 / $636.27	Facility	26	$320.02	$320.02	$636.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $2,137.17	Professional		$475.00	$522.50	$2,137.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $154.00 / $627.37	Professional	26	$140.00	$154.00	$627.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $368.50 / $1,509.81	Professional	TC	$335.00	$368.50	$1,509.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $586.30 / $1,125.00 / $1,471.74	Professional		$586.30	$1,125.00	$1,471.74
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 $430.80 / $787.50 / $1,120.83	Professional	TC	$430.80	$787.50	$1,120.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $937.14 / $1,135.34 / $2,476.32	Professional		$937.14	$1,135.34	$2,476.32
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $246.65 / $301.25 / $742.45	Professional	26	$246.65	$301.25	$742.45
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $649.28 / $839.40 / $1,733.93	Professional	TC	$649.28	$839.40	$1,733.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,462.50 / $1,696.50 / $2,842.92	Professional		$1,462.50	$1,696.50	$2,842.92
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $381.25 / $411.75 / $688.50	Professional	26	$381.25	$411.75	$688.50
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,081.25 / $1,290.90 / $2,163.48	Professional	TC	$1,081.25	$1,290.90	$2,163.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $549.25 / $1,493.75 / $2,799.30	Professional		$549.25	$1,493.75	$2,799.30
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 $975.60 / $1,452.00 / $2,163.48	Professional	TC	$975.60	$1,452.00	$2,163.48
United Facility/Professional Professional Modifier Low / Median / High Price $1,082.09 / $1,600.73 / $2,299.46	Professional		$1,082.09	$1,600.73	$2,299.46
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 $780.48 / $1,170.72 / $1,658.52	Professional	TC	$780.48	$1,170.72	$1,658.52