Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $241.41 / $484.37 / $591.54	Facility	26	$241.41	$484.37	$591.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,722.46	Professional		$475.00	$522.50	$1,722.46
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 / $1,249.22	Professional	TC	$335.00	$368.50	$1,249.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $475.11 / $1,025.00 / $1,192.16	Professional		$475.11	$1,025.00	$1,192.16
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 $359.32 / $717.50 / $925.28	Professional	TC	$359.32	$717.50	$925.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $541.00 / $921.87 / $1,997.05	Professional		$541.00	$921.87	$1,997.05
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $185.18 / $227.07 / $559.08	Professional	26	$185.18	$227.07	$559.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $541.00 / $699.66 / $1,437.98	Professional	TC	$541.00	$699.66	$1,437.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,187.50 / $1,377.50 / $2,304.29	Professional		$1,187.50	$1,377.50	$2,304.29
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 $901.25 / $1,066.00 / $1,785.77	Professional	TC	$901.25	$1,066.00	$1,785.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $442.96 / $1,210.00 / $2,267.73	Professional		$442.96	$1,210.00	$2,267.73
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $250.11 / $348.00 / $518.52	Professional	26	$250.11	$348.00	$518.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $805.13 / $1,198.50 / $1,785.77	Professional	TC	$805.13	$1,198.50	$1,785.77
United Facility/Professional Professional Modifier Low / Median / High Price $860.10 / $1,309.53 / $1,855.17	Professional		$860.10	$1,309.53	$1,855.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.28 / $342.90 / $486.46	Professional	26	$110.28	$342.90	$486.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $644.10 / $966.15 / $1,368.71	Professional	TC	$644.10	$966.15	$1,368.71