Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $319.19 / $656.93 / $782.13	Facility	26	$319.19	$656.93	$782.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,873.43	Professional		$475.00	$522.50	$1,873.43
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 / $1,247.72	Professional	TC	$335.00	$368.50	$1,247.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $514.34 / $1,177.11 / $1,530.36	Professional		$514.34	$1,177.11	$1,530.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $155.51 / $328.34 / $376.03	Professional	26	$155.51	$328.34	$376.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $358.83 / $801.10 / $1,202.03	Professional	TC	$358.83	$801.10	$1,202.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $828.14 / $994.65 / $2,174.59	Professional		$828.14	$994.65	$2,174.59
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $246.65 / $301.25 / $738.54	Professional	26	$246.65	$301.25	$738.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $540.25 / $698.67 / $1,436.05	Professional	TC	$540.25	$698.67	$1,436.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,281.25 / $1,486.25 / $2,472.30	Professional		$1,281.25	$1,486.25	$2,472.30
Premera BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $381.25 / $427.00 / $686.25	Professional	26	$381.25	$427.00	$686.25
Premera BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $900.00 / $1,142.40 / $1,800.00	Professional	TC	$900.00	$1,142.40	$1,800.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $482.33 / $1,391.81 / $2,454.03	Professional		$482.33	$1,391.81	$2,454.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $328.34 / $454.50 / $677.21	Professional	26	$328.34	$454.50	$677.21
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $923.75 / $1,202.03 / $1,890.00	Professional	TC	$923.75	$1,202.03	$1,890.00
United Facility/Professional Professional Modifier Low / Median / High Price $941.70 / $1,412.55 / $2,001.11	Professional		$941.70	$1,412.55	$2,001.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $146.47 / $301.04 / $623.86	Professional	26	$146.47	$301.04	$623.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $640.88 / $961.32 / $1,453.69	Professional	TC	$640.88	$961.32	$1,453.69