Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $279.70 / $279.70 / $279.70	Facility	26	$279.70	$279.70	$279.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.31 / $482.09 / $1,036.92	Professional		$392.31	$482.09	$1,036.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.39 / $96.23 / $398.01	Professional	26	$82.39	$96.23	$398.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $309.93 / $385.85 / $638.90	Professional	TC	$309.93	$385.85	$638.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $493.20 / $1,069.24 / $1,205.58	Professional		$493.20	$1,069.24	$1,205.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $135.38 / $290.33 / $330.09	Professional	26	$135.38	$290.33	$330.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $357.82 / $739.15 / $900.10	Professional	TC	$357.82	$739.15	$900.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $789.61 / $953.91 / $2,066.19	Professional		$789.61	$953.91	$2,066.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $215.10 / $263.66 / $648.51	Professional	26	$215.10	$263.66	$648.51
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $537.66 / $695.76 / $1,417.63	Professional	TC	$537.66	$695.76	$1,417.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,228.75 / $1,341.90 / $2,235.00	Professional		$1,228.75	$1,341.90	$2,235.00
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $332.50 / $359.10 / $594.51	Professional	26	$332.50	$359.10	$594.51
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $896.25 / $985.50 / $1,640.49	Professional	TC	$896.25	$985.50	$1,640.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $458.28 / $1,242.50 / $2,112.60	Professional		$458.28	$1,242.50	$2,112.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $290.33 / $399.00 / $594.51	Professional	26	$290.33	$399.00	$594.51
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $797.85 / $1,101.00 / $1,640.49	Professional	TC	$797.85	$1,101.00	$1,640.49
United Facility/Professional Professional Modifier Low / Median / High Price $770.33 / $1,283.09 / $2,044.41	Professional		$770.33	$1,283.09	$2,044.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $129.16 / $396.12 / $631.16	Professional	26	$129.16	$396.12	$631.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $591.32 / $886.98 / $1,413.25	Professional	TC	$591.32	$886.98	$1,413.25