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 / $2,130.54	Professional		$475.00	$522.50	$2,130.54
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 / $1,504.83	Professional	TC	$335.00	$368.50	$1,504.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $584.82 / $1,125.00 / $1,466.92	Professional		$584.82	$1,125.00	$1,466.92
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 $429.31 / $787.50 / $1,117.21	Professional	TC	$429.31	$787.50	$1,117.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $934.88 / $1,132.44 / $2,466.59	Professional		$934.88	$1,132.44	$2,466.59
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $246.65 / $301.25 / $740.47	Professional	26	$246.65	$301.25	$740.47
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $647.02 / $836.49 / $1,726.12	Professional	TC	$647.02	$836.49	$1,726.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,458.75 / $1,692.15 / $2,838.45	Professional		$1,458.75	$1,692.15	$2,838.45
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 $1,077.50 / $1,288.30 / $2,159.01	Professional	TC	$1,077.50	$1,288.30	$2,159.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $547.10 / $1,487.50 / $2,792.10	Professional		$547.10	$1,487.50	$2,792.10
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 $973.58 / $1,449.00 / $2,159.01	Professional	TC	$973.58	$1,449.00	$2,159.01
United Facility/Professional Professional Modifier Low / Median / High Price $1,080.50 / $1,620.75 / $2,296.06	Professional		$1,080.50	$1,620.75	$2,296.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $147.04 / $451.56 / $640.94	Professional	26	$147.04	$451.56	$640.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $778.88 / $1,168.32 / $1,655.12	Professional	TC	$778.88	$1,168.32	$1,655.12